Provider Demographics
NPI:1740989599
Name:BEAM, ELLEN HUFFAKER (FNP)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:HUFFAKER
Last Name:BEAM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:PARRISH
Other - Last Name:HUFFAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:820 THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-3005
Mailing Address - Country:US
Mailing Address - Phone:423-779-2716
Mailing Address - Fax:
Practice Address - Street 1:5120 HIGHWAY 153
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-4520
Practice Address - Country:US
Practice Address - Phone:423-876-9396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-01
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33458363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily