Provider Demographics
NPI:1376106260
Name:MEDLEY, CATHERINE GRACE (FNP-C)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:GRACE
Last Name:MEDLEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 BRAINERD RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-3729
Mailing Address - Country:US
Mailing Address - Phone:423-826-8000
Mailing Address - Fax:423-826-8015
Practice Address - Street 1:251 N LYERLY ST STE 100
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-2743
Practice Address - Country:US
Practice Address - Phone:423-826-8000
Practice Address - Fax:423-826-8015
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25796363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily