Provider Demographics
NPI:1881219376
Name:PATILLO, RASHUNIKA KEYARRA (RN, BSN, MSN)
Entity Type:Individual
Prefix:MRS
First Name:RASHUNIKA
Middle Name:KEYARRA
Last Name:PATILLO
Suffix:
Gender:F
Credentials:RN, BSN, MSN
Other - Prefix:
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Mailing Address - Street 1:4976 ALPHA LN
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-5470
Mailing Address - Country:US
Mailing Address - Phone:423-308-0280
Mailing Address - Fax:423-308-0281
Practice Address - Street 1:171 BAYLOR SCHOOL RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405-2506
Practice Address - Country:US
Practice Address - Phone:423-267-8506
Practice Address - Fax:423-757-2874
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN27667363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily