Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | APN0000005893 | TN |
N | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | APN0000005893 | TN |
NPI | 1013970300 |
---|---|
Provider Name | Ariel Diane Avant |
First Address | Ooltewah, TN 37363-6422 |
Second Address | Chattanooga, TN 37403-2103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2006 |
Last Update Date | 05/02/2018 |