Healthcare Provider Details

I. General information

NPI: 1932090727
Provider Name (Legal Business Name): ELIZABETH CROWE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 E 4TH ST
CHATTANOOGA TN
37403-1925
US

IV. Provider business mailing address

3601 MAIDEN DR
CHATTANOOGA TN
37412-1517
US

V. Phone/Fax

Practice location:
  • Phone: 423-425-4706
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: