Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | RN223165 | GA |
N | 363LG0600X | Nurse Practitioner - Gerontology | RN223165 | GA |
NPI | 1013476738 |
---|---|
Provider Name | Amy Fouts |
First Address | Chattanooga, TN 37421-1984 |
Second Address | Chattanooga, TN 37421-1984 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2019 |
Last Update Date | 10/03/2021 |