Healthcare Provider Details

I. General information

NPI: 1558313429
Provider Name (Legal Business Name): CHRISTOPHER D STEWART CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 MEDICAL PARK BLVD
BRISTOL TN
37620-7455
US

IV. Provider business mailing address

PO BOX 291264
NASHVILLE TN
37229-1264
US

V. Phone/Fax

Practice location:
  • Phone: 423-878-0232
  • Fax: 615-620-2323
Mailing address:
  • Phone: 615-260-2320
  • Fax: 615-602-2323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN098145
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number901600
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN10779
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: