Provider Demographics
NPI:1821313107
Name:VALADEZ, ELLEN BRITTANY (MD)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:BRITTANY
Last Name:VALADEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:BRITTANY
Other - Last Name:HOSEMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:975 E 3RD ST
Mailing Address - Street 2:ATTN: PROVIDER ENROLLMENT
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2147
Mailing Address - Country:US
Mailing Address - Phone:423-778-9001
Mailing Address - Fax:423-778-4692
Practice Address - Street 1:979 E 3RD ST
Practice Address - Street 2:SUITE C-830
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2136
Practice Address - Country:US
Practice Address - Phone:423-778-9001
Practice Address - Fax:423-778-4692
Is Sole Proprietor?:No
Enumeration Date:2010-03-30
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN546162084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology