Provider Demographics
NPI:1275055394
Name:PLATZER, ASHLEY VANLANDINGHAM (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:VANLANDINGHAM
Last Name:PLATZER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:VIRGINIA
Other - Last Name:VANLANDINGHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1949 GUNBARREL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7133
Mailing Address - Country:US
Mailing Address - Phone:423-495-4345
Mailing Address - Fax:423-495-4934
Practice Address - Street 1:210 WALMART DR
Practice Address - Street 2:
Practice Address - City:SODDY DAISY
Practice Address - State:TN
Practice Address - Zip Code:37379-5022
Practice Address - Country:US
Practice Address - Phone:423-332-6155
Practice Address - Fax:423-332-5293
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3648363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant