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General NPI Number Information
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NPI Number | 1134808678
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Entity Type | Individual
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Provider Name | NICHOLAS DAKOTA CARSWELL FNP-C
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Gender | Male
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Dates
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Enumeration Date | 07/12/2023
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 2339 MCCALLIE AVE STE 300
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City | CHATTANOOGA
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State | TN
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Zip | 37404-3209
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Country | US
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Telephone | 423-086-7335
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Fax |
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Provider Business Mailing Address
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Address Line | 1961 HENEGAR CIR
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City | CHATTANOOGA
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State | TN
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Zip | 37421-5777
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Country | US
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Telephone | 828-423-8745
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Fax | 828-423-8745
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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 | 27469
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 34152
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License Number State | TN
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