Provider Demographics
NPI:1396118113
Name:GINN, CATHERINE KENDALL (APN)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:KENDALL
Last Name:GINN
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 1:979 E 3RD ST STE B-1201
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2192
Mailing Address - Country:US
Mailing Address - Phone:423-778-5864
Mailing Address - Fax:
Practice Address - Street 1:979 E 3RD ST STE B-1201
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2192
Practice Address - Country:US
Practice Address - Phone:423-778-5864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-02
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN20700363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily