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General NPI Number Information
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NPI Number | 1922048156
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Entity Type | Individual
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Provider Name | CHARLES R LARMORE NP-C
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 07/13/2011
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Provider Practice Location Address
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Address Line | 5323 BRAINERD RD STE 104
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City | CHATTANOOGA
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State | TN
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Zip | 37411-5305
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Country | US
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Telephone | 423-240-6112
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Fax |
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Provider Business Mailing Address
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Address Line | 5323 BRAINERD RD
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City | CHATTANOOGA
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State | TN
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Zip | 37411-5305
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Country | US
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Telephone | 423-240-6112
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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 | APN0000008457
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License Number State | TN
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