Provider Demographics
NPI:1841777810
Name:WELBORN, MALLORY CHRISTINE (DNP, FNP-BC PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:MALLORY
Middle Name:CHRISTINE
Last Name:WELBORN
Suffix:
Gender:F
Credentials:DNP, FNP-BC PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 MCCALLIE AVE DEPT 1801
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2598
Mailing Address - Country:US
Mailing Address - Phone:423-425-4438
Mailing Address - Fax:423-425-5527
Practice Address - Street 1:615 MCCALLIE AVE DEPT 1801
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2598
Practice Address - Country:US
Practice Address - Phone:423-425-4438
Practice Address - Fax:423-425-5527
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25879363LF0000X, 363LP0808X
GAGAA-NP000785363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily