Individual
MRS. SANDRA CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
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 90170
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN 9790
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09887577
—
MS
05
—
160584001
—
AR
05
—
3623208
—
TN
01
—
4041055
BLUE CROSS
TN
01
—
430078845
RAILROAD MEDICARE
TN
01
—
99527
BLUE CROSS
AR
Enumeration date
05/17/2006
Last updated
09/08/2015
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