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General NPI Number Information
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NPI Number | 1548133531
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Entity Type | Individual
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Provider Name | ALEXIS TALIAFERRO WILLINGHAM
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Gender | Female
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Dates
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Enumeration Date | 09/25/2025
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 804 N HOLTZCLAW AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1235
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Country | US
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Telephone | 855-612-3494
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Fax |
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Provider Business Mailing Address
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Address Line | 1617 TRUMAN AVE
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City | CHATTANOOGA
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State | TN
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Zip | 37412-3840
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Country | US
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Telephone | 423-463-4134
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 39862
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License Number State | TN
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