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NPI Code Detail

MEDICARE: MELONY E MAGOON APN

MEDICARE: MELONY E MAGOON APN
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
1363LF0000XFamily Nurse PractitionerAPN5237TN

General Provider Information

NPI Number : 1417980871
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELONY E MAGOON APN
Provider Business Mailing Address
First Line : 9510 HEATHWOOD DR
Second Line :
City : OOLTEWAH
State : TN
Zip : 37363-8933
Country : US
Telephone Number : 423-265-2271
Fax Number : 423-785-3454
Provider Business Practice Location Address
First Line : 100 MOCCASIN BEND RD
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37405-4415
Country : US
Telephone Number : 423-265-2271
Fax Number : 423-278-5345
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2006
Last Update Date : 08/03/2011

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Directions to “ MELONY E MAGOON APN” Practice Location

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