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General NPI Number Information
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NPI Number | 1285682906
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Entity Type | Individual
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Provider Name | BARBARA AILEEN ELLER CNNP
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Gender | Female
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 975 E 3RD ST PEDIATRIX MEDICAL GROUP OF TENNESSEE
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City | CHATTANOOGA
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State | TN
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Zip | 37403-2103
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Country | US
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Telephone | 423-778-6172
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Fax | 423-778-6938
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Provider Business Mailing Address
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Address Line | 9234 COBBLESTONE HILL DR
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City | OOLTEWAH
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State | TN
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Zip | 37363-8942
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Country | US
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Telephone | 423-855-5678
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | APN0000010906
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License Number State | TN
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