Healthcare Provider Details

I. General information

NPI: 1033379714
Provider Name (Legal Business Name): JENNIFER BUNN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

672 HILDABRAND RD
OCOEE TN
37361-3444
US

IV. Provider business mailing address

6557 HICKORY BROOK RD
CHATTANOOGA TN
37421-6744
US

V. Phone/Fax

Practice location:
  • Phone: 423-716-8296
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000013421
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: