Individual
SPRING ELAINE CORNAVACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
975 E. THIRD STREET, CHATTANOOGA, TN 37403-2147
(423) 778-7608
(423) 778-2360
Mailing address
PO BOX 11225, CHATTANOOGA, TN 37401-2225
(423) 892-5602
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN124955
TN
163W00000X
Registered Nurse
RN169392
GA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN169392
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009911539
—
AL
05
—
3638075
—
TN
01
—
4156966
BLUE CROSS BLUE SHIELD OF TN
TN
05
—
453654394A
—
GA
05
—
8052759
—
NC
01
—
N356383
WELLCARE (GA MEDICAID)
GA
01
—
P00430484
RAILROAD MEDICARE
—
Enumeration date
08/13/2006
Last updated
03/18/2021
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