Individual
BRETT TEASDALE MAIZE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2341 MCCALLIE AVE, SUITE 402, CHATTANOOGA, TN 37404-3239
(423) 698-3309
(423) 624-6355
Mailing address
PO BOX 3549, CHATTANOOGA, TN 37404-0549
(423) 698-3309
(423) 624-6355
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN10870
TN
367500000X
Certified Registered Nurse Anesthetist
RN122011
TN
367500000X
Certified Registered Nurse Anesthetist
RN156796
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3629077
—
TN
01
—
4017896
BCBS
TN
Enumeration date
02/27/2006
Last updated
07/08/2007
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