Provider Demographics
NPI:1962669242
Name:DUNKEL, KATELYN RACHELLE (APN)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:RACHELLE
Last Name:DUNKEL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 MORRIS HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2817
Mailing Address - Country:US
Mailing Address - Phone:423-903-4436
Mailing Address - Fax:
Practice Address - Street 1:2121 MORRIS HILL RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-2817
Practice Address - Country:US
Practice Address - Phone:423-903-4436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000013251363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3342417Medicare PIN