Provider Demographics
NPI:1982902557
Name:REICH, ANGELA AARON (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:AARON
Last Name:REICH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:ANGELA
Other - Middle Name:CHRISTINE
Other - Last Name:AARON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:1949 GUNBARREL RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3188
Mailing Address - Country:US
Mailing Address - Phone:423-495-4349
Mailing Address - Fax:423-495-4934
Practice Address - Street 1:605 GLENWOOD DR
Practice Address - Street 2:SUITE 303
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1108
Practice Address - Country:US
Practice Address - Phone:423-495-7778
Practice Address - Fax:423-495-7797
Is Sole Proprietor?:No
Enumeration Date:2011-03-07
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21592363L00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000705308OtherANTHEM PIN
KY9343664OtherAETNA PIN
KY7100154580Medicaid
KYP400040875Medicare PIN