Provider Demographics
NPI:1811547201
Name:RUMBLE, MARTHA KATHERINE (PMHNP)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:KATHERINE
Last Name:RUMBLE
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:KATHERINE
Other - Last Name:SCROGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9136 CARISSA DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8848
Mailing Address - Country:US
Mailing Address - Phone:256-794-2477
Mailing Address - Fax:
Practice Address - Street 1:6031 SHALLOWFORD RD STE 113
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-1984
Practice Address - Country:US
Practice Address - Phone:423-825-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-159517163W00000X
TN241318163W00000X
TN26695363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse