Individual
MS. JENNIFER D. STANFIELD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
910 BLACKFORD ST, CHATTANOOGA, TN 37403-1405
(423) 778-6011
(865) 539-8008
Mailing address
PO BOX 634811, CINCINNATI, OH 45263-4811
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0000001060
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4104212
BLUE CROSS
TN
Enumeration date
07/15/2006
Last updated
11/20/2007
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