Healthcare Provider Details

I. General information

NPI: 1245605310
Provider Name (Legal Business Name): ALIE MCFALL GEREN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2015
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 MOUNTAIN VIEW RD STE 109
OOLTEWAH TN
37363-6685
US

IV. Provider business mailing address

6401 MOUNTAIN VIEW RD STE 109
OOLTEWAH TN
37363-6685
US

V. Phone/Fax

Practice location:
  • Phone: 423-495-5951
  • Fax: 423-495-5999
Mailing address:
  • Phone: 423-495-5951
  • Fax: 423-495-5999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20649
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: