Jooma, Khairunnissa

Jooma, Khairunnissa is an individual health care provider with primary practice located at 2205 Mccallie Ave , Chattanooga TN 37404-3230. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Jooma, Khairunnissa can be contacted via phone (423) 697-8385.

Contact Information

Primary practice address
2205 Mccallie Ave Chattanooga TN 37404-3230
Phone: (423) 697-8385
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC 1953 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APN0000013348 Tennessee

Profile Details

NPI number 1639102791
LBN Legal business name Jooma, Khairunnissa
Credentials DNP/PMHNP-BC/LPC
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 9th, 2006
Last updated Dec 6th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639102791 NPPES
Tennessee MEDICAID 5441854
Tennessee Other P00967911

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