Organization
TENNESSEE ANESTHESIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY LEIGH LLOYD (ADMINISTRATION)
(423) 392-6100
Entity
Organization
Contact information
Practice address
2204 PAVILION DR, SUITE 105, KINGSPORT, TN 37660-4657
(423) 392-0344
(423) 392-6159
Mailing address
2204 PAVILION DR, SUITE 105, KINGSPORT, TN 37660-4657
(423) 392-6100
(423) 392-6159
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1525088
—
TN
01
—
4306528
BCBSTN
TN
Enumeration date
07/13/2011
Last updated
11/28/2023
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