Individual
HARRY GLENN LANNOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1800 MEDICAL CENTER PKWY, SUITE 330, MURFREESBORO, TN 37129-2567
(615) 396-4464
(615) 396-6748
Mailing address
PO BOX 1252, MURFREESBORO, TN 37133-1252
(615) 396-4464
(615) 396-6748
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN105174
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3144083
BLUE CROSS BLUE SHIELD
TN
05
—
3628616
—
TN
01
—
4182581
BCBS EFFECTIVE 5/1/08
TN
01
—
430052095
RR MEDICARE
TN
Enumeration date
05/20/2006
Last updated
10/15/2010
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