Individual
KRISTY BORUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
975 E 3RD ST, CHATTANOOGA, TN 37403-2147
(423) 778-7000
Mailing address
975 E 3RD ST, CHATTANOOGA, TN 37403-2147
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
21720
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q046666
—
TN
Enumeration date
01/25/2019
Last updated
05/14/2024
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