Individual
MARK EDWARD CHILDRESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
2333 MCCALLIE AVE, CHATTANOOGA, TN 37404-3258
(423) 698-6061
Mailing address
931 POLO PL, CHATTANOOGA, TN 37405-3041
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
32473
TN
363LF0000X
Family Nurse Practitioner
32473
TN
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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