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General NPI Number Information
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NPI Number | 1790538544
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Entity Type | Organization
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Legal Business Name | CHUC, LLC
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Dates
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Enumeration Date | 04/10/2024
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 7625 CHAPMAN HWY STE 107
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City | KNOXVILLE
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State | TN
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Zip | 37920-2353
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Country | US
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Telephone | 865-983-1310
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Fax | 865-273-9319
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Provider Business Mailing Address
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Address Line | 216 CENTERVIEW DR STE 100
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City | BRENTWOOD
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State | TN
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Zip | 37027-3226
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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 | SENIOR CREDENTIALING SPECIALIST
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Name | TYLER TERWILLIGER
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Credential |
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Telephone | 615-656-2750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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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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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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