Healthcare Provider Details

I. General information

NPI: 1780351213
Provider Name (Legal Business Name): DUSTIN FINK CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 MEDICAL CENTER PKWY STE 330
MURFREESBORO TN
37129-2586
US

IV. Provider business mailing address

304 BRISTON CT
MURFREESBORO TN
37127-7230
US

V. Phone/Fax

Practice location:
  • Phone: 615-410-7873
  • Fax:
Mailing address:
  • Phone: 210-379-3802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number36124
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number202172
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: