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PATRICK LEE HERSCHELMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
907 E LAMAR ALEXANDER PKWY, MARYVILLE, TN 37804-5015
(865) 983-7211
(865) 983-8043
Mailing address
PO BOX 24776, CHATTANOOGA, TN 37422
(877) 288-1799
(423) 892-5838

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0001229638
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
10459
TN
367500000X
Certified Registered Nurse Anesthetist
140556
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100021714
PHP TENNCARE
TN
01
127254
BLUE CROSS
MO
05
3626241
TN
01
4096641
BLUE CROSS
TN
01
477005
HEALTHLINK
MO
05
915929715
MO
01
P00201599
MEDICARE TRAVELERS
TN
Enumeration date
06/20/2006
Last updated
11/21/2015
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