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Organization

SURGERY CENTER ANESTHESIA PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SYLVIA EVANS CRNA (PRESIDENT)
(573) 686-5550
Entity
Organization

Contact information

Practice address
207 STONEBRIDGE BLVD, JACKSON, TN 38305-2040
(573) 686-5550
Mailing address
2 QUAIL CREEK DR, JACKSON, TN 38305-8866
(573) 686-5550

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
09367
RR MEDICARE GROUP
TN
01
3012913
BCBS TN GROUP
TN
01
3021400
TN BCBS
TN
05
3605893
TN
05
3623620
TN
01
CA6103
RR MEDICARE
TN
Enumeration date
09/20/2005
Last updated
07/21/2022
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