AMBER PROVENZANO (NPI# 1780076752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780076752 |
| Entity Type | Individual |
| Full Name | AMBER PROVENZANO |
| Practice Address |
6734 Lee Hwy Chattanooga TN 37421-2423 |
| Practice Telephone | 4238990431 |
| Practice Fax Number | 4234999552 |
| Mailing Telephone | 4238990431 |
| Mailing Fax Number | 4234999552 |
| Enumeration Date | 2015-02-26 |
| Last Update Date | 2020-04-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
19802 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN196795 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1005 Executive Dr Ste 101, Hixson, TN 373437904 | 4238990431 | 4234999552 |
| 1506 N Thornton Ave Ste C, Dalton, GA 307208515 | 4238990431 | 4234999552 |
| 163 Walnut Grove Church Rd Ste 101, Dayton, TN 373216105 | 4238990431 | 4234999552 |
| 24 Mountain View Dr, Kimball, TN 373475477 | 4238990431 | 4234999552 |
| 325 Market St Ste 100, Chattanooga, TN 374021226 | 4238990431 | 4234999552 |
| 3760 Ocoee Pl Nw Ste 100, Cleveland, TN 373125637 | 4238990431 | 4234999552 |
| 4630 Battlefield Pkwy, Ringgold, GA 307368004 | 4238990431 | 4234999552 |
| Street Address |
6734 LEE HWY |
| City | CHATTANOOGA |
| State | TN |
| Zip Code | 37421-2423 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356310932 | Hyman Moses Kaplan | Allergy & Immunology | 6734 Lee Hwy, Chattanooga, TN 37421-2423 | 2006-03-16 |
| 1356896955 | Michael Leland | Nurse Practitioner | 6734 Lee Hwy, Chattanooga, TN 37421-2423 | 2016-08-24 |
| 1083083380 | Christy Kinsey | Nurse Practitioner | 6734 Lee Hwy, Chattanooga, TN 37421-2423 | 2015-09-17 |
| 1225422280 | Jessica Sebastian Van Mason | Pediatrics | 6734 Lee Hwy, Chattanooga, TN 37421-2423 | 2015-03-26 |
| 1609278365 | Shandra Bucy Burnett | Registered Nurse | 6734 Lee Hwy, Chattanooga, TN 37421-2423 | 2014-09-24 |
| 1245589514 | Donna Kaye Bearden | Nurse Practitioner | 6734 Lee Hwy, Chattanooga, TN 37421-2423 | 2012-09-02 |
| 1245586668 | Lena Marie Satterfield | Nurse Practitioner | 6734 Lee Hwy, Chattanooga, TN 37421-2423 | 2012-08-03 |
| 1457647893 | Megan Elizabeth Moore | Nurse Practitioner | 6734 Lee Hwy, Chattanooga, TN 37421-2423 | 2011-06-23 |
| 1023325180 | Brittany Taylor Hamby | Nurse Practitioner | 6734 Lee Hwy, Chattanooga, TN 37421-2423 | 2010-09-09 |
| 1528290137 | Teri Shannan Hayes | Nurse Practitioner | 6734 Lee Hwy, Chattanooga, TN 37421-2423 | 2009-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558991588 | Janera Pentiah | Physician Assistant | 1360 Mackey Branch Dr, Chattanooga, TN 37421 | 2020-01-17 |
| 1750921367 | Stephan Ian Belasco | Counselor | 1360 Mackey Branch Dr., Chattanooga, TN 37421 | 2020-01-11 |
| 1932745817 | Sound Living Inc | Community/Behavioral Health | 6727 Heritage Business Court, Suite 720, Chattanooga, TN 37421 | 2019-11-26 |
| 1245875046 | Chattanooga Compounding Pharmacy Inc. | Pharmacy | 7032 East Brainerd Rd, Suite A-b, Chattanooga, TN 37421 | 2019-11-15 |
| 1083105803 | Trauma and Addiction Recovery Center | Counselor | 6727 Heritage Business Ct Ste 718, Chattanooga, TN 37421 | 2018-05-29 |
| 1497257448 | Claude James Bowden | Counselor | 7372 Applegate Lane, Chattanooga, TN 37421 | 2018-03-06 |
| 1093213332 | Preferred Primary Care | Clinic/Center | 6031 Shallowford Rd Ste 105, Chattanooga, TN 37421 | 2018-01-31 |
| 1124526777 | Elizabeth Marie Wright | Nurse Practitioner | 6130 Shallowford Rd Ste 101, Chattanooga, TN 37421 | 2018-01-30 |
| 1477065712 | Publix Tennessee LLC | Durable Medical Equipment & Medical Supplies | 7326 Mccutcheon Rd, Chattanooga, TN 37421 | 2017-10-26 |
| 1144746645 | Mobility At Home LLC | Contractor | 6307 E Brainerd Rd, Chattanooga, TN 37421 | 2017-08-16 |
| Find all providers in zip 37421 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043828692 | Michelle Colby | Nurse Practitioner | 1050 Givens Rd, Chattanooga, TN 37421-4370 | 2020-07-20 |
| 1750999553 | Julia Clare Cervantes Aguilar | Nurse Practitioner | 3756 Knollwood Dr, Chattanooga, TN 37415-4203 | 2020-07-17 |
| 1447876743 | Cathleen Marie Cornett | Nurse Practitioner | 979 E 3rd St Ste C-300, Chattanooga, TN 37403-2136 | 2020-06-23 |
| 1487279139 | Roxy Gazaway | Nurse Practitioner | 721 Glenwood Dr Ste W560, Chattanooga, TN 37404-1129 | 2020-06-09 |
| 1801410253 | Stacey Buckner | Nurse Practitioner | 207 Booth Rd, Chattanooga, TN 37411-2702 | 2020-06-02 |
| 1073158630 | Jerry Lynn Reed Jr. | Nurse Practitioner | 7480 Ziegler Rd Ste 150, Chattanooga, TN 37421-4947 | 2019-11-07 |
| 1508411729 | Jerin C Alexander | Nurse Practitioner | 6918 Shallowford Rd Ste 226, Chattanooga, TN 37421-1552 | 2019-08-05 |
| 1295388841 | Ann Mercy Binoy | Nurse Practitioner | 425 Cumberland St # 110, Chattanooga, TN 37404-1909 | 2019-07-23 |
| 1528610466 | Kristina Wagner Daly | Nurse Practitioner | 504 E 17th St, Chattanooga, TN 37408-2107 | 2019-07-11 |
| 1023679909 | Megan Elizabeth Coffey | Nurse Practitioner | 3321 Montview Dr, Chattanooga, TN 37411-3524 | 2019-06-22 |
| Find all providers in CHATTANOOGA | ||||
| City | CHATTANOOGA |
| Zip Code | 37421 |
Please comment or provide details below to improve the information on AMBER PROVENZANO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.