Individual
JONATHAN O ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
708 W FOREST AVE, JACKSON, TN 38301-3901
(731) 927-7070
(731) 927-7075
Mailing address
1804 HIGHWAY 45 BYP, SUITE 604, JACKSON, TN 38305-4436
(731) 660-8759
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
12440
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3638387
—
TN
Enumeration date
12/29/2006
Last updated
05/14/2024
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