Organization
SOUTH FORK ANESTHESIA ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN C JESSEE CRNA (OWNER)
(865) 310-6371
Entity
Organization
Contact information
Practice address
107 QUAIL RIDGE WAY, JONESBOROUGH, TN 37659-4166
(865) 310-6371
Mailing address
3101 BROWNS MILL RD STE 6-207, JOHNSON CITY, TN 37604-4100
(423) 758-6690
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
04/29/2021
Last updated
06/25/2021
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