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Individual

CASEY M ELLINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(731) 541-5000
Mailing address
410 N CEDAR BLUFF RD, SUITE 300, KNOXVILLE, TN 37923-3623
(865) 342-8900
(865) 691-0843

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
179740
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
21725
TN

Other

Enumeration date
09/13/2016
Last updated
04/23/2018
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