| NPI | 1104599513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA HARLAN Director Of Provider Enrollment 615-577-6340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2022-07-21 |