Healthcare Provider Details

I. General information

NPI: 1518005214
Provider Name (Legal Business Name): ALLISON T MOOREHEAD CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON ADKINS CRNA

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 06/16/2023
Certification Date: 06/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2341 MCCALLIE AVE SUITE 402
CHATTANOOGA TN
37404-3239
US

IV. Provider business mailing address

194 WOOD BLUFF RD
WINCHESTER TN
37398-2343
US

V. Phone/Fax

Practice location:
  • Phone: 423-698-3309
  • Fax:
Mailing address:
  • Phone: 931-962-9723
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number075673
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: