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General NPI Number Information
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NPI Number | 1518708130
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Entity Type | Organization
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Legal Business Name | ML PRIMARY CARE PLLC
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 1425 S MOORE RD STE C
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City | CHATTANOOGA
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State | TN
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Zip | 37412-2836
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Country | US
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Telephone | 423-287-6805
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Fax | 423-287-6806
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Provider Business Mailing Address
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Address Line | 207 CENTRAL DR
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City | CHATTANOOGA
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State | TN
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Zip | 37421-5107
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Country | US
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Telephone | 832-867-0760
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Fax |
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Authorized Official
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Title or Position | DNP
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Name | MARIA MARTINEZ
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Credential | DNP
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Telephone | 832-867-0760
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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 |
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License Number State |
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