Provider Demographics
NPI:1134850027
Name:EUBANKS, HADLEA (APRN)
Entity type:Individual
Prefix:
First Name:HADLEA
Middle Name:
Last Name:EUBANKS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9006 BRYAN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37341-8000
Mailing Address - Country:US
Mailing Address - Phone:423-827-3812
Mailing Address - Fax:
Practice Address - Street 1:1751 GUNBARREL RD STE 200
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-7162
Practice Address - Country:US
Practice Address - Phone:423-894-1355
Practice Address - Fax:423-899-8066
Is Sole Proprietor?:No
Enumeration Date:2022-06-21
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNCNM07839367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife