Provider Demographics
NPI:1700443470
Name:SCENIC CITY WELLNESS
Entity Type:Organization
Organization Name:SCENIC CITY WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MICHALLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:423-255-4506
Mailing Address - Street 1:PO BOX 25164
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37422-5164
Mailing Address - Country:US
Mailing Address - Phone:423-643-8000
Mailing Address - Fax:423-643-8100
Practice Address - Street 1:105 LEE PARKWAY DR STE A
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-6708
Practice Address - Country:US
Practice Address - Phone:423-643-8000
Practice Address - Fax:423-643-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-28
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty