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General NPI Number Information
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NPI Number | 1275251100
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Entity Type | Individual
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Provider Name | REBECCA CHAFFIN FNP
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Gender | Female
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Dates
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Enumeration Date | 08/17/2022
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 1604 LAMONS LN STE 202
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City | JOHNSON CITY
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State | TN
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Zip | 37604-5290
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Country | US
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Telephone | 423-529-3591
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Fax |
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Provider Business Mailing Address
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Address Line | 577 CHEROKEE MOUNTAIN RD
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City | JONESBOROUGH
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State | TN
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Zip | 37659-6638
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Country | US
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Telephone | 423-534-2575
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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 | 31894
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License Number State | TN
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