Provider Demographics
NPI:1518005214
Name:MOOREHEAD, ALLISON T (CRNA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:T
Last Name:MOOREHEAD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:ADKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:194 WOOD BLUFF RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:TN
Mailing Address - Zip Code:37398-2343
Mailing Address - Country:US
Mailing Address - Phone:931-962-9723
Mailing Address - Fax:
Practice Address - Street 1:2341 MCCALLIE AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3239
Practice Address - Country:US
Practice Address - Phone:423-698-3309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN075673367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered