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General NPI Number Information
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NPI Number | 1447066089
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Entity Type | Organization
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Legal Business Name | CHATTANOOGA STATE COMMUNITY COLLEGE STUDENT HEALTH CLINIC
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 4501 AMNICOLA HIGHWAY STUDENT CENTER SUITE 133
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City | CHATTANOOGA
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State | TN
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Zip | 37406
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Country | US
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Telephone | 423-697-5522
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Fax |
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Provider Business Mailing Address
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Address Line | 4501 AMNICOLA HIGHWAY STUDENT CENTER SUITE 133
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City | CHATTANOOGA
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State | TN
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Zip | 37406
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Country | US
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Telephone | 423-697-5522
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF STUDENT HEALTH SERVICES
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Name | MRS. HEATHER MONTGOMERY
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Credential | FNP-BC
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Telephone | 423-697-5522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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