Individual
CAROL JO WILBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2501 CITICO AVE, CHATTANOOGA, TN 37404-1127
(423) 697-2000
(423) 697-2320
Mailing address
2501 CITICO AVE, CHATTANOOGA, TN 37404-1127
(423) 697-2000
(423) 697-2320
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
APN0000027836
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27836
TN APN LICENSE
TN
Enumeration date
08/21/2020
Last updated
08/05/2021
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