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Individual

JOHN BRATCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1411 BADDOUR PAKEWAY, LEBANON, TN 37087
(615) 256-1064
Mailing address
344 SEA BISCUIT DR, GALLATIN, TN 37066-3899
(615) 513-4498

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
9324
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10069706
AMERIGROUP
TN
05
3606001
TN
01
4006049
BCBS
TN
01
430061613
RAILROAD MEDICARE
TN
01
74396979
KY MEDICAID
KY
Enumeration date
06/12/2006
Last updated
03/19/2008
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