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Individual

MS. AWILDA MARRERO LABONNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
13 W KENT ST STE 103, CHATTANOOGA, TN 37405-9913
(423) 648-2273
(423) 206-4625
Mailing address
13 W KENT ST STE 103, CHATTANOOGA, TN 37405-9913
(423) 648-2273
(423) 206-4625

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
03307
TN
363AM0700X
Medical Physician Assistant
Primary
03307
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
363AMO700X
TAXONOMY
IL
Enumeration date
03/22/2006
Last updated
03/07/2023
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