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General NPI Number Information
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NPI Number | 1629206644
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Entity Type | Individual
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Provider Name | ELIZABETH A JANSEN D.O.
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Gender | Female
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Dates
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Enumeration Date | 06/29/2009
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 4610 BRAINERD RD
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City | CHATTANOOGA
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State | TN
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Zip | 37411-3835
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Country | US
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Telephone | 423-541-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 2803 KELL RD
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City | SIGNAL MOUNTAIN
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State | TN
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Zip | 37377-1020
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Country | US
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Telephone | 515-249-4237
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | N/A
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036.136484
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 036136484
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 6078
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License Number State | TN
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