Healthcare Provider Details

I. General information

NPI: 1609279645
Provider Name (Legal Business Name): RACHEL CARBONI BALDWIN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHEL CHRISTINE CARBONI RN

II. Dates (important events)

Enumeration Date: 10/05/2014
Last Update Date: 10/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

603 YOUNG AVE
CHATTANOOGA TN
37405-4334
US

V. Phone/Fax

Practice location:
  • Phone: 865-342-8900
  • Fax:
Mailing address:
  • Phone: 423-718-6806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number19714
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: