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General NPI Number Information
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NPI Number | 1801134911
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Entity Type | Individual
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Provider Name | VANESSA HAYNES PHIPPS CPNP
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Gender | Female
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Dates
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Enumeration Date | 01/24/2013
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Last Update Date | 04/09/2018
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Provider Practice Location Address
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Address Line | 6172 AIRWAYS BLVD STE 122
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City | CHATTANOOGA
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State | TN
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Zip | 37421-2915
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Country | US
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Telephone | 423-622-1551
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Fax |
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Provider Business Mailing Address
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Address Line | 1318 UNIVERSITY AVE
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City | SEWANEE
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State | TN
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Zip | 37375
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Country | US
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Telephone | 931-598-9761
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Fax | 931-598-5038
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 17071
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License Number State | TN
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