Individual
MS. SUSAN R ST. JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
787 D SAIN RD, MANCHESTER, TN 37355-3940
(931) 409-1238
Mailing address
787 D SAIN RD, MANCHESTER, TN 37355-3940
(931) 409-1238
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
3009223
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
46243
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3624683
—
TN
01
—
4061907
BLUECROSS
TN
05
—
7100387060
—
KY
01
—
P0009555
RAILROAD MEDICARE
TN
Enumeration date
06/13/2006
Last updated
05/09/2017
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