Healthcare Provider Details

I. General information

NPI: 1821140310
Provider Name (Legal Business Name): PREFERRED ANESTHESIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22024 RHEA COUNTY HWY
SPRING CITY TN
37381-5243
US

IV. Provider business mailing address

PO BOX 16068
HIGH POINT NC
27261-6068
US

V. Phone/Fax

Practice location:
  • Phone: 423-365-6222
  • Fax:
Mailing address:
  • Phone: 336-882-4615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. TERRI L BROTHERS
Title or Position: OWNER
Credential: CRNA
Phone: 423-843-3901