Individual
LAVATA FAYE O'NEAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
501 20TH ST, SUITE 606, KNOXVILLE, TN 37916-1809
(865) 546-8040
(865) 541-2787
Mailing address
501 20TH ST, SUITE 606, KNOXVILLE, TN 37916-1809
(865) 546-8040
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
22586
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100042400
PHP TENNCARE
TN
05
—
3603447
—
TN
01
—
4088472
BLUECARE
TN
01
—
P00193047
TRAVELERS MEDICARE
TN
Enumeration date
10/18/2006
Last updated
05/14/2009
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