Healthcare Provider Details

I. General information

NPI: 1336179464
Provider Name (Legal Business Name): DOROTHY E HRAY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 11/09/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 E LAMAR ALEXANDER PKWY
MARYVILLE TN
37804-5015
US

IV. Provider business mailing address

PO BOX 10708
KNOXVILLE TN
37939-0708
US

V. Phone/Fax

Practice location:
  • Phone: 865-983-7211
  • Fax: 865-450-9374
Mailing address:
  • Phone: 865-766-8894
  • Fax: 865-450-9374

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN85978
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: