Individual
MR. RICHARD WAYNE MERRYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8271
Mailing address
PO BOX 680326, FRANKLIN, TN 37068-0326
(615) 521-0595
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN0000110589
TN
367500000X
Certified Registered Nurse Anesthetist
0024168155
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
10092
TN
367500000X
Certified Registered Nurse Anesthetist
3003900
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000217461
ANTHEM BCBS
KY
05
—
7400067000
—
KY
Enumeration date
03/14/2007
Last updated
12/12/2025
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