Individual
MISS JENNY LYNN PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1401 CARTER STREET SUITE 102, CHATTANOOGA, TN 37402
(423) 933-3397
(423) 933-3398
Mailing address
1401 CARTER STREET SUITE 102, CHATTANOOGA, TN 37402
(423) 933-3397
(423) 933-3398
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1299
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0140208
UNITED HEALTHCARE
TN
01
—
2000307
BCBS OF TN
TN
05
—
3663990
—
TN
01
—
970027904
RAILROAD MEDICARE
TN
01
—
FP62706
WORKERS COMP
TN
01
—
TN0101
JOHN DEERE
TN
Enumeration date
10/04/2006
Last updated
06/11/2018
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