Individual
MARY TERESA RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3601 TVC, NASHVILLE, TN 37232-0001
(615) 322-3000
Mailing address
3601 TVC, NASHVILLE, TN 37232-0001
(615) 322-3000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
044149
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN9232
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3057450
BCBS NUMBER
TN
05
—
3622180
—
TN
05
—
74008228
—
KY
Enumeration date
09/22/2005
Last updated
08/26/2015
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