Individual
AMANDA BRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
501 20TH ST, SUITE 606, KNOXVILLE, TN 37916-1809
(865) 546-8040
Mailing address
501 20TH ST, SUITE 606, KNOXVILLE, TN 37916-1809
(865) 546-8040
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
12018
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11007826
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100050100
PHP TENNCARE
TN
05
—
3636343
—
TN
Enumeration date
06/20/2006
Last updated
09/16/2020
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