Healthcare Provider Details

I. General information

NPI: 1336320886
Provider Name (Legal Business Name): MINNIE BERNICE TROUPE APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2007
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MOCCASIN BEND RD
CHATTANOOGA TN
37405-4415
US

IV. Provider business mailing address

100 MOCCASIN BEND RD
CHATTANOOGA TN
37405-4415
US

V. Phone/Fax

Practice location:
  • Phone: 423-265-2271
  • Fax: 423-785-3305
Mailing address:
  • Phone: 423-265-2271
  • Fax: 423-785-3305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: