Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 11033 | TN |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 11033 | TN |
NPI | 1043450620 |
---|---|
Provider Name | Christy Dawn Tittsworth |
First Address | Hixson, TN 37343-5470 |
Second Address | Hixson, TN 37343-7900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/02/2009 |
Last Update Date | 21/11/2018 |