Individual
MRS. SUSANNA RAE CROUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC, FNP
Contact information
Practice address
2341 MCCALLIE AVENUE. PLAZA 3, STE. 406., GASTROENTEROLOGY ASSOCIATES OF CHATTANOOGA, PC, CHATTANOOGA, TN 37404-3229
(423) 648-8204
(423) 493-1908
Mailing address
2341 MCCALLIE AVENUE. PLAZA 3, STE. 406, GASTROENTEROLOGY ASSOCIATES OF CHATTANOOGA, PC, CHATTANOOGA, TN 37404-3229
(423) 648-8204
(423) 493-1908
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
13252
TN
363LF0000X
Family Nurse Practitioner
13252APNFNP
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I503608
MEDICARE PTAN
TN
Enumeration date
06/12/2008
Last updated
09/27/2013
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