Healthcare Provider Details

I. General information

NPI: 1770522617
Provider Name (Legal Business Name): ASHLEY D GUTHRIE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 MCBRIEN RD
EAST RIDGE TN
37412-3223
US

IV. Provider business mailing address

6170 SHALLOWFORD RD 101
CHATTANOOGA TN
37421-1892
US

V. Phone/Fax

Practice location:
  • Phone: 423-894-3589
  • Fax: 423-892-3378
Mailing address:
  • Phone: 423-648-4500
  • Fax: 423-855-7563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN0000008243
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: