Provider Demographics
NPI:1912086042
Name:GARIE, ELIZABETH D (FNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:D
Last Name:GARIE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2102
Mailing Address - Country:US
Mailing Address - Phone:423-209-8000
Mailing Address - Fax:423-209-8241
Practice Address - Street 1:5625 HIGHWAY 60
Practice Address - Street 2:
Practice Address - City:BIRCHWOOD
Practice Address - State:TN
Practice Address - Zip Code:37308-5155
Practice Address - Country:US
Practice Address - Phone:423-961-0446
Practice Address - Fax:423-961-2344
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10672363L00000X
IAA128021363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ003063Medicaid
Q38864Medicare UPIN
TN3648562Medicaid