Organization
MID STATE ENDO UAP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTEN OCONNOR (OFFICER/AUTHORIZED OFFICIAL)
(615) 376-7315
Entity
Organization
Contact information
Practice address
1115 DOW ST, SUITE A, MURFREESBORO, TN 37130-2487
(615) 848-9234
(615) 893-3188
Mailing address
1115 DOW ST STE A, MURFREESBORO, TN 37130-2487
(615) 848-9234
(615) 893-3188
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
01/16/2014
Last updated
10/26/2022
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