Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 38022 | TN |
NPI | 1194949792 |
---|---|
Provider Name | Mrs. Elaina Rodela |
First Address | Cleveland, TN 37312-4309 |
Second Address | Chattanooga, TN 37408-1912 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2007 |
Last Update Date | 20/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G83536 | (02) |