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Individual

MARY SANDRA LATHREM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
256 FORT SANDERS WEST BLVD, KNOXVILLE, TN 37922-3355
(859) 699-9534
Mailing address
940 BOB KIRBY RD, KNOXVILLE, TN 37923-1910
(859) 699-9534

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
3008752
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
38874
TN
367500000X
Certified Registered Nurse Anesthetist
APRN9284688
FL

Other

Enumeration date
09/18/2014
Last updated
06/23/2025
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