Individual
MELISSA STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
975 E. THIRD ST, CHATTANOOGA, TN 37403-2147
(423) 778-7608
(423) 778-2360
Mailing address
PO BOX 11225, CHATTANOOGA, TN 37401-2225
(423) 892-5602
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN111442
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN11749
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009933493
—
AL
05
—
3635803
—
TN
01
—
4115498
BLUE CROSS BLUE SHIELD TN
TN
05
—
445713084A
—
GA
01
—
N451247
WELLCARE (GA MEDICAID)
GA
01
—
P00264965
RAILROAD MEDICARE
TN
Enumeration date
12/15/2006
Last updated
02/08/2010
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