Healthcare Provider Details

I. General information

NPI: 1346396306
Provider Name (Legal Business Name): BJARNE M BORRESEN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 01/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 N CEDAR BLUFF RD SUITE 300
KNOXVILLE TN
37923-3623
US

IV. Provider business mailing address

PO BOX 535575
ATLANTA GA
30353-5595
US

V. Phone/Fax

Practice location:
  • Phone: 423-698-3309
  • Fax: 423-624-6355
Mailing address:
  • Phone: 865-342-8900
  • Fax: 865-691-0843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPN12376
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: