Individual
TAIT WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
315 HOSPITAL DR, MADISON, TN 37115-5030
(615) 732-7671
Mailing address
851 TRAFALGAR CT STE 200E, MAITLAND, FL 32751-7420
(407) 667-0444
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN0000193806
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
30970
TN
Other
Enumeration date
09/07/2021
Last updated
10/18/2023
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