Healthcare Provider Details

I. General information

NPI: 1780733402
Provider Name (Legal Business Name): CUMBERLAND ANESTHESIA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 11/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 HOSPITAL DR
CARTHAGE TN
37030-1083
US

IV. Provider business mailing address

PO BOX 291704
NASHVILLE TN
37229-1704
US

V. Phone/Fax

Practice location:
  • Phone: 615-735-1560
  • Fax:
Mailing address:
  • Phone: 615-620-2320
  • Fax: 615-620-2323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. WAYNE E WINFREE
Title or Position: MANAGING PARTNER
Credential: CRNA
Phone: 615-735-2807