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General NPI Number Information
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NPI Number | 1053132316
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Entity Type | Individual
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Provider Name | TAJUANA MICHELLE PRATER FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/21/2024
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 4700 BATTLEFIELD PKWY STE 360
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City | RINGGOLD
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State | GA
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Zip | 30736-5175
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Country | US
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Telephone | 423-698-0304
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Fax |
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Provider Business Mailing Address
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Address Line | 605 GLENWOOD DR STE 105
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1151
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Country | US
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Telephone | 423-544-3805
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 36906
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License Number State | TN
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