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NPI Code Detail

MEDICARE: LAVENDER MEDI SPA

MEDICARE: LAVENDER MEDI SPA
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 Practitioner

General Provider Information

NPI Number : 1851242903
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAVENDER MEDI SPA
Provider Business Mailing Address
First Line : 1334 MACKEY BRANCH DR STE 103
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-3471
Country : US
Telephone Number : 423-251-1694
Fax Number : 423-592-8656
Provider Business Practice Location Address
First Line : 1334 MACKEY BRANCH DR STE 103
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-3471
Country : US
Telephone Number : 423-251-1694
Fax Number : 423-592-8656
Authorized Official
Title or Position : NP/OWNER
Name : SHARLOTTE JEAN MANLEY
Credential : FNP-C
Telephone Number : 423-251-1694
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/05/2026

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Directions to “LAVENDER MEDI SPA ” Practice Location

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