Provider Demographics
NPI:1639347180
Name:ESTELLA-WALTER, KATE E (ANP)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:E
Last Name:ESTELLA-WALTER
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 LEE HWY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-1799
Mailing Address - Country:US
Mailing Address - Phone:423-894-0432
Mailing Address - Fax:423-894-0475
Practice Address - Street 1:7000 LEE HWY
Practice Address - Street 2:SUITE 600
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1799
Practice Address - Country:US
Practice Address - Phone:423-894-0432
Practice Address - Fax:423-894-0475
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13170363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP01346126OtherRAILROAD MEDICARE
TN3341642Medicaid
TN103I504036Medicare PIN