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General NPI Number Information
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NPI Number | 1447929500
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Entity Type | Individual
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Provider Name | ZACHARY WAYNE CRIDER
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Gender | Male
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Dates
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Enumeration Date | 09/10/2021
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 979 E 3RD ST
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City | CHATTANOOGA
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State | TN
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Zip | 37403-2136
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Country | US
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Telephone | 423-602-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 923 MOUNT VERNON RD
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City | TUNNEL HILL
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State | GA
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Zip | 30755-9321
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Country | US
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Telephone | 706-463-5809
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Fax |
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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 | 30265
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License Number State | TN
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