Provider Demographics
NPI:1598191025
Name:DUFF, DONNA REED (FNP-C)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:REED
Last Name:DUFF
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 1:975 E. THIRD STREET
Mailing Address - Street 2:ATTN: PROVIDER ENROLLMENT
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403
Mailing Address - Country:US
Mailing Address - Phone:423-778-8179
Mailing Address - Fax:423-778-8180
Practice Address - Street 1:979 E. THIRD STREET
Practice Address - Street 2:SUITE # B-601
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403
Practice Address - Country:US
Practice Address - Phone:423-778-8179
Practice Address - Fax:423-778-8180
Is Sole Proprietor?:No
Enumeration Date:2013-09-16
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily