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General NPI Number Information
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NPI Number | 1609883008
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Entity Type | Individual
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Provider Name | REBECCA M RAY CRNA
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Gender | Female
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 4713 PAPERMILL DR
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City | KNOXVILLE
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State | TN
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Zip | 37909-1908
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Country | US
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Telephone | 865-696-2906
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10941
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City | KNOXVILLE
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State | TN
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Zip | 37939-0941
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Country | US
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Telephone | 865-696-2906
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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 | 10078
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 109366
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 045057
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License Number State | TN
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