Healthcare Provider Details

I. General information

NPI: 1730870643
Provider Name (Legal Business Name): KAITLIN ELIZABETH RAMSEY OWENS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2023
Last Update Date: 10/08/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 NORTH OCOEE RD
CLEVELAND TN
37311
US

IV. Provider business mailing address

2415 MCCALLIE AVE
CHATTANOOGA TN
37404-3322
US

V. Phone/Fax

Practice location:
  • Phone: 423-624-2696
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6206
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: