MEDICARE: JOHN E TANNER CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	51277	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3134720	OTHER	TN	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376522045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN E TANNER CRNA

Provider Business Mailing Address
First Line	:	3841 GREEN HILLS VILLAGE DR STE 200
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37215-2691
Country	:	US
Telephone Number	:	615-936-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1215 21ST AVE S
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37232-0014
Country	:	US
Telephone Number	:	615-343-6336
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	03/29/2022

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