Organization
BONOM ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVAN DAVID BONOM CRNA (PRESIDENT/OWNER)
(865) 594-2047
Entity
Organization
Contact information
Practice address
1720 WEST AVE, SUITE 101, CROSSVILLE, TN 38555-4066
(931) 787-1940
Mailing address
PO BOX 16068, HIGH POINT, NC 27261-6068
(888) 447-7220
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
03/24/2014
Last updated
03/24/2014
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