Healthcare Provider Details

I. General information

NPI: 1619294675
Provider Name (Legal Business Name): BROOK CHAREE HIBBS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2010
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
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 3549
CHATTANOOGA TN
37404-0549
US

V. Phone/Fax

Practice location:
  • Phone: 865-342-9011
  • Fax: 865-691-0843
Mailing address:
  • Phone: 423-698-3309
  • Fax: 423-624-6355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number156334
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number15045
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: