Individual
JENNIFER WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
110 29TH AVE N STE 202, NASHVILLE, TN 37203-1448
(615) 327-4304
Mailing address
110 29TH AVE N STE 202, NASHVILLE, TN 37203-1448
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
76042
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009940758
—
AL
05
—
3638341
—
TN
01
—
4153543
BCBS
TN
Enumeration date
01/15/2007
Last updated
09/06/2007
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