Provider Demographics
NPI:1598155434
Name:BENNETT, ROXANNE YVONNE (NP-C)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:YVONNE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:ROXANNE
Other - Middle Name:
Other - Last Name:PHILLIPS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7305 JARNIGAN RD STE 260
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4895
Mailing Address - Country:US
Mailing Address - Phone:423-708-5050
Mailing Address - Fax:423-708-5055
Practice Address - Street 1:7305 JARNIGAN RD STE 260
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-4895
Practice Address - Country:US
Practice Address - Phone:423-708-5050
Practice Address - Fax:423-708-5055
Is Sole Proprietor?:No
Enumeration Date:2015-01-30
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN215472363L00000X
TNAPN0000021108363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner