Individual
JACKIE DODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
Mailing address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
(615) 327-7940
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
040297
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1551481
—
LA
01
—
3053819
BCBS NUMBER
TN
05
—
3607505
—
TN
05
—
74402975
—
KY
Enumeration date
09/21/2005
Last updated
08/28/2012
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