MEDICARE: MEGHAN LEIGH WHITEHEAD CPNP-PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	APN0000028687	TN

General Provider Information

NPI Number	:	1386218923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN LEIGH WHITEHEAD CPNP-PC

Provider Business Mailing Address
First Line	:	1042 E 3RD ST STE 103
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37403-2161
Country	:	US
Telephone Number	:	423-624-4846
Fax Number	:

Provider Business Practice Location Address
First Line	:	1303 TAFT HWY
Second Line	:
City	:	SIGNAL MOUNTAIN
State	:	TN
Zip	:	37377-3207
Country	:	US
Telephone Number	:	423-886-7529
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2021
Last Update Date	:	10/16/2024

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