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General NPI Number Information
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NPI Number | 1487164901
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Entity Type | Individual
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Provider Name | CHARITI BLACK NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/11/2017
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Last Update Date | 02/03/2026
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Provider Practice Location Address
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Address Line | 105 LEE PARKWAY DR STE A
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City | CHATTANOOGA
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State | TN
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Zip | 37421-6708
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Country | US
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Telephone | 423-643-8000
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Fax | 855-730-7240
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Provider Business Mailing Address
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Address Line | 6802 LEE HWY
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2444
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Country | US
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Telephone | 423-313-3688
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Fax | 855-730-7240
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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 | 22769
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License Number State | TN
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