Individual
CORY F BLACKWELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2341 MCCALLIE AVE, SUITE 402, CHATTANOOGA, TN 37404-3239
(423) 698-3309
(423) 624-6355
Mailing address
PO BOX 73709, NEWNAN, GA 30271-3709
(770) 251-2060
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
APN09974
TN
367500000X
Certified Registered Nurse Anesthetist
RN103349
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
RN111991
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3626058
—
TN
01
—
4059111
BCBS
TN
Enumeration date
02/28/2006
Last updated
04/09/2019
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