Healthcare Provider Details

I. General information

NPI: 1982770772
Provider Name (Legal Business Name): SARAH W BUTLER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2006
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

975 E 3RD ST
CHATTANOOGA TN
37403-2103
US

IV. Provider business mailing address

PO BOX 11225
CHATTANOOGA TN
37401-2225
US

V. Phone/Fax

Practice location:
  • Phone: 423-778-7806
  • Fax:
Mailing address:
  • Phone: 423-892-9483
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN71309
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: