Healthcare Provider Details

I. General information

NPI: 1174597017
Provider Name (Legal Business Name): LENEE FRANCES MCPHERSON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7330 N 16TH ST STE A200
PHOENIX AZ
85020-5295
US

IV. Provider business mailing address

2640 IVY RD
EADS TN
38028-3216
US

V. Phone/Fax

Practice location:
  • Phone: 602-200-9021
  • Fax:
Mailing address:
  • Phone: 615-289-9015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN0000010993
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberCRNA130
License Number StateAZ
# 3
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN0000096244
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: