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Individual

KENNETH LAMAR WILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1607 SOUTH LOCUST AVENUE, LAWRENCEBURG, TN 38464
(615) 620-2320
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
RN1-063395
AL
163W00000X
Registered Nurse
RN44231
TN
163W00000X
Registered Nurse
RN799782
FL
367500000X
Certified Registered Nurse Anesthetist
1-063395
AL
367500000X
Certified Registered Nurse Anesthetist
AC000125
MD
367500000X
Certified Registered Nurse Anesthetist
Primary
APN08946
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01069642
AMERIGROUP TENNCARE ONLY
TN
05
3632860
TN
05
406122500
MD
01
4064894
BLUE CROSS/BLUE SHIELD OF TN
TN
Enumeration date
04/25/2006
Last updated
08/05/2010
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