Individual
MR. PATRICK C HARRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1900 EXETER RD, SUITE 210, GERMANTOWN, TN 38138-2954
(901) 818-2183
(901) 682-9522
Mailing address
4300 WOODCREST DR, JONESBORO, AR 72404-9567
(870) 243-2938
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R81788
AR
367500000X
Certified Registered Nurse Anesthetist
16912
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
C002934
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05582309
—
MS
01
—
1245585405
CHAMPUS/TRICARE
TN
05
—
1529774
—
TN
05
—
193905001
—
AR
01
—
4331670
BCBST
TN
Enumeration date
07/13/2012
Last updated
03/20/2021
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