Healthcare Provider Details

I. General information

NPI: 1467405092
Provider Name (Legal Business Name): ADA I BATISTA-BARON RN MSN CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 12/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5000 ALPHA LN
HIXSON TN
37343-4054
US

IV. Provider business mailing address

PO BOX 22696
CHATTANOOGA TN
37422-2696
US

V. Phone/Fax

Practice location:
  • Phone: 423-499-5655
  • Fax: 423-499-8085
Mailing address:
  • Phone: 423-499-5655
  • Fax: 423-499-8085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN0000098064
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: