1447388384 NPI number — MELISSA MARIE GUINN M.S., A.T.C.

Table of content: MELISSA MARIE GUINN M.S., A.T.C. (NPI 1447388384)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447388384 NPI number — MELISSA MARIE GUINN M.S., A.T.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUINN
Provider First Name:
MELISSA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., A.T.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SEIDEL
Provider Other First Name:
MELISSA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S., A.T.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1447388384
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3521 BURNS TRL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHATTANOOGA
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37419-1201
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-425-5547
Provider Business Mailing Address Fax Number:
423-425-2266

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 HOUSTON ST
Provider Second Line Business Practice Location Address:
METRO ANNEX 202
Provider Business Practice Location Address City Name:
CHATTANOOGA
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37403-3409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-425-5547
Provider Business Practice Location Address Fax Number:
423-425-2266
Provider Enumeration Date:
03/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2255A2300X , with the licence number:  682 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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