Individual
GARY A BLINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
975 E THIRD ST, CHATTANOOGA, TN 37403-2147
(423) 778-7806
(423) 778-2360
Mailing address
PO BOX 11225, CHATTANOOGA, TN 37401-2225
(423) 892-5602
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN46237
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN08976
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000580566A
—
GA
05
—
009709980
—
AL
01
—
3049757
BLUE CROSS BLUE SHIELD TN
TN
05
—
3604262
—
TN
01
—
430030816
RAILROAD MEDICARE
TN
05
—
8052354
—
NC
01
—
N366445
WELLCARE (GA MEDICAID)
GA
Enumeration date
11/24/2006
Last updated
01/20/2010
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