Provider Demographics
NPI:1093952475
Name:GARMON, MARISSA ANNE (MSN, RN, CPNP)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:ANNE
Last Name:GARMON
Suffix:
Gender:F
Credentials:MSN, RN, CPNP
Other - Prefix:
Other - First Name:MARISSA
Other - Middle Name:ANNE
Other - Last Name:BUNCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:7320 SHALLOWFORD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2626
Mailing Address - Country:US
Mailing Address - Phone:423-648-6483
Mailing Address - Fax:423-648-6497
Practice Address - Street 1:7320 SHALLOWFORD RD
Practice Address - Street 2:SUITE B
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2626
Practice Address - Country:US
Practice Address - Phone:423-648-6483
Practice Address - Fax:423-648-6497
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13882363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics