Provider Demographics
NPI:1639303530
Name:CHADWELL, ELIZABETH A NOE (FNP - BC)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:A NOE
Last Name:CHADWELL
Suffix:
Gender:F
Credentials:FNP - BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:180 SHELLY DR
Mailing Address - Street 2:
Mailing Address - City:SHARPS CHAPEL
Mailing Address - State:TN
Mailing Address - Zip Code:37866-2200
Mailing Address - Country:US
Mailing Address - Phone:423-526-7381
Mailing Address - Fax:865-278-1126
Practice Address - Street 1:180 SHELLY DR
Practice Address - Street 2:
Practice Address - City:SHARPS CHAPEL
Practice Address - State:TN
Practice Address - Zip Code:37866-2200
Practice Address - Country:US
Practice Address - Phone:423-526-7381
Practice Address - Fax:865-278-1126
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2012-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14078363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1518247Medicaid