| NPI | 1912953381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI WALLACE Credentialing Coordinator/Hr 615-385-3704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: TN MD017219) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner (Licence: TN APN6541) | |
| 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 038094) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2024-01-12 |