Individual
MRS. HAZEL CHARLENE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
435 2ND STREET, NEWPORT, TN 37821-3703
(865) 777-0909
(865) 777-0910
Mailing address
12752 KINGSTON PIKE, STE E202, KNOXVILLE, TN 37934-0948
(865) 777-0909
(865) 777-0910
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
10522
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
114338
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100031526
PHP TENNCARE
TN
01
—
3151319
BLUECARE
TN
05
—
3902431
—
TN
05
—
3902437
—
TN
01
—
4195271
BLUE CROSS/BLUE SHIELD
TN
01
—
430059022
MEDICARE TRAVELERS
TN
01
—
P00813082
RAILROAD MEDICARE PIN
TN
Enumeration date
06/20/2006
Last updated
01/14/2011
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