Provider Demographics
NPI:1033618228
Name:CHONG, HANNAH (APRN)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:CHONG
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 DORCHESTER RD STE 117
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-4432
Mailing Address - Country:US
Mailing Address - Phone:423-267-5060
Mailing Address - Fax:
Practice Address - Street 1:1301 DORCHESTER RD STE 117
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-4432
Practice Address - Country:US
Practice Address - Phone:423-267-5060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-02
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23441363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN23441OtherFAMILY