Basic Information
Provider Information
NPI: 1538816517
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAWYER
FirstName: LATONYA
MiddleName: RNEA
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1923 SULPHUR SPRINGS RD
Address2:  
City: MORRISTOWN
State: TN
PostalCode: 378135654
CountryCode: US
TelephoneNumber: 4233179344
FaxNumber: 4237142355
Practice Location
Address1: 5600 BRAINERD RD
Address2:  
City: CHATTANOOGA
State: TN
PostalCode: 374115310
CountryCode: US
TelephoneNumber: 4232664588
FaxNumber: 8653420103
Other Information
ProviderEnumerationDate: 03/09/2022
LastUpdateDate: 03/09/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/09/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
376K00000X  Y Nursing Service Related ProvidersNurse's Aide 

No ID Information.


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