Individual
CONWAY ELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
412 DEVONIA ST, HARRIMAN, TN 37748-2009
(423) 882-1323
Mailing address
PO BOX 11446, KNOXVILLE, TN 37939-1446
(865) 602-2117
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1108988/4824A
KY
Other
Enumeration date
05/18/2006
Last updated
07/08/2007
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