Individual
PATRICIA L DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
412 DEVONIA ST, HARRIMAN, TN 37748-2009
(865) 882-1323
Mailing address
PO BOX 51406, KNOXVILLE, TN 37950-1406
(865) 524-2739
(865) 524-2739
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN33794
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3148701
BCBS
TN
01
—
4105331
BLUE CROSS OF TENNESSEE
TN
Enumeration date
10/04/2005
Last updated
02/12/2009
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