Provider Demographics
NPI:1619587581
Name:EARHART, MILLER ANNE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:MILLER
Middle Name:ANNE
Last Name:EARHART
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:MILLER
Other - Middle Name:ANNE
Other - Last Name:EARHART WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:615 MCCALLIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2504
Mailing Address - Country:US
Mailing Address - Phone:423-425-2266
Mailing Address - Fax:
Practice Address - Street 1:615 MCCALLIE AVE
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2504
Practice Address - Country:US
Practice Address - Phone:423-425-2266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-05
Last Update Date:2020-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27767363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner