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General NPI Number Information
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NPI Number | 1144528894
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Entity Type | Individual
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Provider Name | MARCIE L BLEDSOE CRNA
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Gender | Female
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Dates
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Enumeration Date | 03/04/2011
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Last Update Date | 03/04/2011
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Provider Practice Location Address
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Address Line | 1850 OLD KNOXVILLE RD
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City | TAZEWELL
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State | TN
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Zip | 37879-3625
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Country | US
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Telephone | 423-626-4211
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 252
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City | TAZEWELL
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State | TN
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Zip | 37879-0252
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Country | US
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Telephone | 800-204-0099
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Fax | 336-882-2215
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 15584
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License Number State | TN
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