Provider Demographics
NPI:1316712946
Name:QUALLS, KHRISTEN NOEL (APN)
Entity type:Individual
Prefix:
First Name:KHRISTEN
Middle Name:NOEL
Last Name:QUALLS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 DESALES AVE STE F1009
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1161
Mailing Address - Country:US
Mailing Address - Phone:423-624-5200
Mailing Address - Fax:423-697-2320
Practice Address - Street 1:2525 DESALES AVE STE F1009
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1161
Practice Address - Country:US
Practice Address - Phone:423-624-5200
Practice Address - Fax:423-697-2320
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34750363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily