Individual provider · Type 1 NPI

Justin Michael Ellison

Nurse Practitioner · Chattanooga, TN

NPI number 1245688928 Active

Practice location

1949 Gunbarrel Rd Ste 206
Chattanooga, TN 37421-7133

Call (423) 495-4349 Map

Fax (423) 495-4934

Mailing address

800 Bradbury Dr SE Ste 116
Albuquerque, NM 87106-4310

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse First Assistant 163WR0006X31438 (TN)
Nurse Practitioner 363L00000X31438 (TN)
Registered Nurse 163W00000X9344794 (FL)
Nurse Practitioner 363L00000X60350 (NM)
Nurse Practitioner 363L00000XN360677930 (WA)
Nurse Practitioner Primary 363L00000XCP003314 (SD)
Registered Nurse 163W00000X196881 (TN)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1245688928

Justin Michael Ellison's National Provider Identifier is 1245688928, issued on Jun 2, 2016. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Chattanooga, TN. The record was last updated on Aug 27, 2026.