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General NPI Number Information
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NPI Number | 1720736507
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Entity Type | Individual
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Provider Name | ERIC HARRISON GANDY FNP-C
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Gender | Male
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Dates
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Enumeration Date | 03/11/2022
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Last Update Date | 03/11/2022
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Provider Practice Location Address
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Address Line | 251 N LYERLY ST STE 100
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City | CHATTANOOGA
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State | TN
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Zip | 37404-2743
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Country | US
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Telephone | 423-826-8000
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Fax | 423-702-7917
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Provider Business Mailing Address
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Address Line | 328 CHEROKEE BLVD APT 321
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City | CHATTANOOGA
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State | TN
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Zip | 37405-4658
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Country | US
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Telephone | 601-832-6188
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 28910
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License Number State | TN
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