IndividualActive
Ian Mall
NPI 1144689456 · Home Health Clinical Nurse Specialist · Ooltewah, TN
Provider details
- NPI number
- 1144689456
- Entity type
- Individual
- Primary specialty
- Home Health Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 20836 (TN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
9981 Forrest Dr
Ooltewah, TN 37363-8300
Phone: (423) 362-8192
Approximate (ZIP-level) locationGet directions
Mailing address
9981 Forrest Dr
Ooltewah, TN 37363-8300
Registry dates
- Enumerated
- 2016-02-15
- Last updated
- 2016-02-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.