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Individual

EDWARD W LANEVILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
651 DUNLOP LN, CLARKSVILLE, TN 37040-5015
(931) 551-1795
Mailing address
1817A MADISON ST, STE 1, CLARKSVILLE, TN 37043-2930
(931) 551-1795

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
52447
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3602477
TN
Enumeration date
05/03/2006
Last updated
01/14/2009
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