Individual
MR. JEREMY FENDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1900 EXETER RD, SUITE 210, GERMANTOWN, TN 38138-2954
(901) 818-2160
(901) 682-9522
Mailing address
1900 EXETER RD, SUITE 210, GERMANTOWN, TN 38138-2954
(901) 818-2160
(901) 682-9522
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN 147039
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN 10544
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08152327
—
MS
05
—
161283001
—
AR
05
—
3634116
—
TN
01
—
4098869
BLUE CROSS
TN
01
—
83990
BLUE CROSS
AR
01
—
P00178338
RAILROAD MEDICARE
TN
Enumeration date
05/19/2006
Last updated
06/09/2011
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