Individual
SUSAN MARIE METHVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1607 N LOCUST AVE, LAWRENCEBURG, TN 38464-2213
(931) 762-6571
(615) 620-2323
Mailing address
PO BOX 440013, NASHVILLE, TN 37244-0013
(615) 620-2320
(615) 620-2323
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN1-044989
AL
163W00000X
Registered Nurse
RN1193101
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN09255
TN
367500000X
Certified Registered Nurse Anesthetist
APN1-044989
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01036208
AMERIGROUP TENNCARE - STAA PAR
TN
05
—
3626663
—
TN
01
—
4064942
BC/BS TN - STAA
TN
Enumeration date
06/13/2006
Last updated
08/23/2010
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