Healthcare Provider Details

I. General information

NPI: 1154774958
Provider Name (Legal Business Name): ASHLEY SHERAE HUNTER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2016
Last Update Date: 12/16/2021
Certification Date: 12/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4980 ALPHA LN
HIXSON TN
37343-5470
US

IV. Provider business mailing address

4976 ALPHA LN
HIXSON TN
37343-5470
US

V. Phone/Fax

Practice location:
  • Phone: 423-497-5359
  • Fax: 423-877-5208
Mailing address:
  • Phone: 423-308-0280
  • Fax: 423-308-0281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number21394
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: