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General NPI Number Information
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NPI Number | 1558969428
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Entity Type | Individual
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Provider Name | RYLEE CHARLES
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Gender | Female
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Dates
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Enumeration Date | 10/13/2020
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 7450 TYNER RD
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City | CHATTANOOGA
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State | TN
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Zip | 37421-1078
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Country | US
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Telephone | 423-698-6871
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Fax |
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Provider Business Mailing Address
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Address Line | 401 OLD PLEASANT GROVE RD APT 938
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City | MOUNT JULIET
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State | TN
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Zip | 37122-7317
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0000216853
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 28893
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License Number State | TN
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