Provider Demographics
NPI:1619584778
Name:DE COUTO, TATIANE ALMEIDA
Entity type:Individual
Prefix:MRS
First Name:TATIANE
Middle Name:ALMEIDA
Last Name:DE COUTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11732 BATES RD
Mailing Address - Street 2:
Mailing Address - City:APISON
Mailing Address - State:TN
Mailing Address - Zip Code:37302-9716
Mailing Address - Country:US
Mailing Address - Phone:352-642-3735
Mailing Address - Fax:
Practice Address - Street 1:2339 MCCALLIE AVE STE 300
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3209
Practice Address - Country:US
Practice Address - Phone:423-508-6733
Practice Address - Fax:423-508-6744
Is Sole Proprietor?:No
Enumeration Date:2020-09-23
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000032525363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily