Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 42107 | TN |
NPI | 1083757033 |
---|---|
Provider Name | Dr. Catherine Ann Chidester |
First Address | Memphis, TN 38111-6103 |
Second Address | Germantown, TN 38138-2208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 08/07/2007 |