| NPI | 1902849706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L JACKSON Senior Dir. Of Provider Enrollment 615-465-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 367500000X Nurse Anesthetist, Certified Registered | |
| Enumeration Date | 2006-06-13 |
| Last Update Date | 2022-04-12 |