Individual
PHYLLIS BACHUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
Mailing address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
038992
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3057201
BCBS NUMBER
TN
05
—
3605882
—
TN
05
—
74389925
—
KY
Enumeration date
07/18/2005
Last updated
08/11/2010
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