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Individual

SEAN A. AVAKIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
975 E. THIRD STREET, CHATTANOOGA, TN 37403-2147
(423) 778-7608
(423) 778-2360
Mailing address
PO BOX 11225, CHATTANOOGA, TN 37401-2225
(423) 892-5602
(423) 892-5838

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN137996
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN14341
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1053542209
TRICARE/CHAMPUS
05
114625
AL
05
1515536
TN
01
4236775
BLUE CROSS BLUE SHIELD TN
TN
05
8053728
NC
05
854664272A
GA
Enumeration date
08/06/2009
Last updated
09/17/2010
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