Individual
CHARLES R LARMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
5323 BRAINERD RD, STE 104, CHATTANOOGA, TN 37411-5305
(423) 240-6112
Mailing address
5323 BRAINERD RD, CHATTANOOGA, TN 37411-5305
(423) 240-6112
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN0000008457
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3929319
—
TN
01
—
4088118
BCBS TN
TN
01
—
954895317
TRICARE
TN
01
—
P0013368
RAILROAD MEDICARE
TN
Enumeration date
06/07/2006
Last updated
07/13/2011
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