Individual
ASHLEY LAUREN FEDUSENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
979 E 3RD ST STE A540A550, CHATTANOOGA, TN 37403-2136
(423) 778-2867
(423) 778-8182
Mailing address
7887 EDEN CT, CHATTANOOGA, TN 37421-4865
(423) 785-7637
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
60391
TN
207Q00000X
Family Medicine Physician
86562
GA
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
60391
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2016
Last updated
10/27/2021
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