Individual
KATY B DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2341 MCCALLIE AVE, SUITE 402, CHATTANOOGA, TN 37404-3239
(423) 698-3309
(423) 624-6355
Mailing address
PO BOX 3549, CHATTANOOGA, TN 37404-0549
(423) 698-3309
(423) 624-6355
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN16546
TN
367500000X
Certified Registered Nurse Anesthetist
RN153283
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528119
—
TN
01
—
4323069
BCBS OF TN
TN
01
—
P01054337
RAILROAD MEDICARE
—
Enumeration date
04/02/2012
Last updated
05/03/2013
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