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General NPI Number Information
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NPI Number | 1245086008
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Entity Type | Individual
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Provider Name | HOLLY RUSCH CPM-TN
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Gender | Female
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Dates
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Enumeration Date | 04/24/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 6245 VANCE RD STE 101
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City | CHATTANOOGA
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State | TN
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Zip | 37421-4836
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Country | US
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Telephone | 678-923-9399
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Fax | 423-558-2377
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Provider Business Mailing Address
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Address Line | 270 COWART MOUNTAIN TRL
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City | WALESKA
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State | GA
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Zip | 30183-2240
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Country | US
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Telephone |
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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 | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 151
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License Number State | TN
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