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General NPI Number Information
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NPI Number | 1134760630
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Entity Type | Individual
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Provider Name | ALYSE HOLMES CRNA
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Gender | Female
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Dates
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Enumeration Date | 10/05/2019
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 1247 RIVERFRONT PKWY # 100
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City | CHATTANOOGA
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State | TN
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Zip | 37402-2108
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Country | US
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Telephone | 423-206-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 3004 EASTON AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37415-5857
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Country | US
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Telephone | 423-661-4374
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 26565
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License Number State | TN
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