Healthcare Provider Details
I. General information
NPI: 1336221928
Provider Name (Legal Business Name): AERO ANESTHESIA, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/20/2006
Last Update Date: 06/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
401 SEWELL DR
SPARTA TN
38583-1223
US
IV. Provider business mailing address
PO BOX 440167
NASHVILLE TN
37244-0167
US
V. Phone/Fax
- Phone: 931-738-9211
- Fax:
- Phone: 615-620-2320
- Fax: 615-620-2323
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
KEVIN
CRAWFORD
Title or Position: PARTNER
Credential: CRNA
Phone: 615-620-2320