Individual
CLAUDE JEFFERSON CASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2503 AUDUBON LANE, OWENS X RDS, AL 35763
(256) 536-9799
Mailing address
2503 AUDUBON LANE, OWENS X RDS, AL 35763
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1-050929
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
APN 10279
TN
367500000X
Certified Registered Nurse Anesthetist
RN 123648
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1507932
—
TN
01
—
4194609
BLUE CROSS BLUE SHIELD
TN
05
—
7100057190
—
KY
01
—
SSN
TRICARE STANDARD
TN
01
—
TAX ID
COVENTRY HEALTHCARE
TN
Enumeration date
06/30/2006
Last updated
04/03/2009
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