Individual
CHARLES HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 W 4TH ST, SUITE 310, COOKEVILLE, TN 38501-2448
(931) 528-7877
(931) 526-3261
Mailing address
100 W 4TH ST, SUITE 310, COOKEVILLE, TN 38501-2448
(931) 528-7877
(931) 526-3261
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
103828
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
9983
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3629637
—
TN
01
—
4112812
BCBS
TN
05
—
74003583
—
KY
Enumeration date
10/21/2005
Last updated
08/12/2010
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