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Organization

LAKEWAY REGIONAL ANESTHESIA SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID OLSEN CRNA (MGR)
(813) 287-5718
Entity
Organization

Contact information

Practice address
726 MCFARLAND ST, MORRISTOWN, TN 37814-3989
(813) 287-5718
(813) 287-5728
Mailing address
DEPT 888022, KNOXVILLE, TN 37995-8022
(813) 287-5718
(813) 287-5728

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3732162
TN
Enumeration date
12/14/2006
Last updated
11/30/2011
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