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General NPI Number Information
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NPI Number | 1114747193
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Entity Type | Individual
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Provider Name | JEONGA BYEON
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Gender | Female
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 2358 LIFESTYLE WAY STE 212
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City | CHATTANOOGA
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State | TN
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Zip | 37421-4904
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Country | US
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Telephone | 423-521-1100
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Fax | 423-521-1200
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Provider Business Mailing Address
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Address Line | 136 BATTLEFIELD CROSSING CT
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City | RINGGOLD
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State | GA
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Zip | 30736-5176
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Country | US
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Telephone | 706-277-7311
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Fax | 706-529-7210
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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 | 37292
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License Number State | TN
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