Individual
KENTRY S ADAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1265 EAST COLLEGE STREET, PULASKI, TN 38478
(615) 620-2320
(615) 620-2323
Mailing address
PO BOX 291264, NASHVILLE, TN 37229-1264
(615) 620-2320
(615) 620-2323
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN10647
TN
367500000X
Certified Registered Nurse Anesthetist
051663
TN
367500000X
Certified Registered Nurse Anesthetist
28156078A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN10647
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009944020
—
AL
01
—
3157794
BCBS NUMBER
TN
05
—
3631090
—
TN
01
—
4055319
BC/BS OF TN
TN
05
—
74002445
—
KY
Enumeration date
07/18/2005
Last updated
01/23/2019
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