Individual
BRYAN KEITH POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
110 29TH AVE N, SUITE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
(615) 327-7940
Mailing address
110 29TH AVE N, SUITE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
(615) 327-7940
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3009680
KY
367500000X
Certified Registered Nurse Anesthetist
RN082617
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000562075B
—
GA
01
—
10065639
AMERIGROUP
GA
01
—
430077287
RAILROAD MEDICARE
GA
05
—
AN0418
—
SC
Enumeration date
05/04/2006
Last updated
10/22/2015
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