Provider Demographics
NPI:1043827041
Name:GAINS, ZAMARIA DAVION LOUISE
Entity Type:Individual
Prefix:
First Name:ZAMARIA
Middle Name:DAVION LOUISE
Last Name:GAINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6216 AIRPARK DR
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2988
Mailing Address - Country:US
Mailing Address - Phone:423-899-0024
Mailing Address - Fax:423-899-5688
Practice Address - Street 1:6216 AIRPARK DR
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2988
Practice Address - Country:US
Practice Address - Phone:423-899-0024
Practice Address - Fax:423-899-5688
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28295363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health