Provider Demographics
NPI:1619684420
Name:DODD, ELANI MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:ELANI
Middle Name:MARIE
Last Name:DODD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ELANI
Other - Middle Name:MARIE
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1067 RIVERFRONT PKWY
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37402-2194
Mailing Address - Country:US
Mailing Address - Phone:423-602-9530
Mailing Address - Fax:
Practice Address - Street 1:4312 HOLIDAY INN EXPRESS WAY NORTHWEST SUITE 102
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37312
Practice Address - Country:US
Practice Address - Phone:423-331-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32824363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily