Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | APN0000011201 | TN |
NPI | 1114985579 |
---|---|
Provider Name | Ms. Carla Ann Metz |
First Address | Chattanooga, TN 37415-3511 |
Second Address | Chattanooga, TN 37403-1405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 08/07/2007 |