Individual
NAN KIMBRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3024 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072-3132
(615) 851-6033
(615) 851-2018
Mailing address
3024 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072-3132
(615) 851-6033
(615) 851-2018
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN9076
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10069855
AMERIGROUP
TN
05
—
3602391
—
TN
01
—
4093087
BCBS
TN
01
—
74365230
KY MEDICAID
TN
01
—
P00225105
RAILROAD MEDICARE
TN
Enumeration date
06/16/2006
Last updated
07/08/2010
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