Individual
CLINTON PETERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1019 RIVER BEND DR, COOKEVILLE, TN 38506-5975
(931) 397-5724
Mailing address
1019 RIVER BEND DR, COOKEVILLE, TN 38506-5975
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN000177585
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
22180
TN
Other
Enumeration date
12/13/2016
Last updated
07/19/2017
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