Provider Demographics
NPI:1326757311
Name:BILLINGSLEY, MEGAN ELISE (DNP)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ELISE
Last Name:BILLINGSLEY
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5616 BRAINERD RD STE 208
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-5376
Mailing Address - Country:US
Mailing Address - Phone:423-265-3561
Mailing Address - Fax:
Practice Address - Street 1:5616 BRAINERD RD STE 208
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-5376
Practice Address - Country:US
Practice Address - Phone:423-265-3561
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN313428363LF0000X
TN36438363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily