Provider Demographics
NPI:1700978533
Name:SMALLEY, CHARLOTTE A (APRN, BC)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:A
Last Name:SMALLEY
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1751 GUNBARREL RD
Mailing Address - Street 2:STE 200
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7162
Mailing Address - Country:US
Mailing Address - Phone:423-697-7843
Mailing Address - Fax:423-697-7564
Practice Address - Street 1:4843 HIXSON PIKE STE C
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-4478
Practice Address - Country:US
Practice Address - Phone:423-870-3700
Practice Address - Fax:423-877-3289
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNRN040411363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNRN040411OtherSTATE LICENSE
TNRN040411OtherSTATE LICENSE
TNMS0445076OtherDEA