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General NPI Number Information
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NPI Number | 1861731887
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Entity Type | Individual
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Provider Name | JOHN JAMES GEMMELL CRNA
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Gender | Male
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Dates
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Enumeration Date | 02/12/2013
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Last Update Date | 05/09/2014
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Provider Practice Location Address
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Address Line | 1 MEDICAL PARK BLVD
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City | BRISTOL
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State | TN
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Zip | 37620-7430
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Country | US
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Telephone | 423-844-2686
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Fax |
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Provider Business Mailing Address
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Address Line | 275 ROBIN CIR
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City | BRISTOL
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State | VA
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Zip | 24202-5923
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Country | US
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Telephone | 713-703-8264
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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 | 91319
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License Number State | TN
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