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Individual

STACY LYNN MCKINNEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1100 E. THIRD STREET, SUITE G-102, CHATTANOOGA, TN 37403-2147
(423) 778-8988
(423) 778-8982
Mailing address
975 E. THIRD STREET, ATTN: PROVIDER ENROLLMENT, CHATTANOOGA, TN 37403-2147
(423) 778-8988
(423) 778-8982

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1142
TN
363AM0700X
Medical Physician Assistant
4247
GA

Other

Enumeration date
07/02/2007
Last updated
11/01/2017
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