Provider Demographics
NPI:1811343551
Name:CHARNLEY, KATHERINE STONE (DO)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:STONE
Last Name:CHARNLEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:MARIE
Other - Last Name:STONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1645 S MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-5998
Mailing Address - Country:US
Mailing Address - Phone:931-484-7531
Mailing Address - Fax:
Practice Address - Street 1:1645 S MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38555-5998
Practice Address - Country:US
Practice Address - Phone:931-484-7531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-12
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3638207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine