Provider Demographics
NPI:1760782890
Name:GARRETT, KATHLEEN CROWNOVER (CNM)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:CROWNOVER
Last Name:GARRETT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7490 ZIEGLER RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3156
Mailing Address - Country:US
Mailing Address - Phone:423-648-6020
Mailing Address - Fax:423-648-6025
Practice Address - Street 1:7490 ZIEGLER RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3156
Practice Address - Country:US
Practice Address - Phone:423-648-6020
Practice Address - Fax:423-648-6025
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006816367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife