Provider Demographics
NPI:1962536631
Name:JOHNSON, CAROLE HIGHLANDER (FNP-C)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:HIGHLANDER
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CAROLE
Other - Middle Name:ELAINE
Other - Last Name:CULVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1949 GUNBARREL RD STE 206
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-7133
Mailing Address - Country:US
Mailing Address - Phone:423-495-4345
Mailing Address - Fax:423-495-4934
Practice Address - Street 1:725 GLENWOOD DR STE E500
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1138
Practice Address - Country:US
Practice Address - Phone:423-495-2635
Practice Address - Fax:423-495-2638
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12586363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3341129Medicaid
TN4214452OtherBCBS - TENNESSEE
TN33411292Medicare PIN