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Individual

LUCAS JOHN MOERSDORF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C.R.N.A.

Contact information

Practice address
990 OAK RIDGE TURNPIKE, MMC ANESTHESIA PC, OAK RIDGE, TN 37830-6976
(919) 858-6303
(770) 237-1124
Mailing address
PO BOX 5059, OAK RIDGE, TN 37831-5059
(919) 858-6303
(770) 237-1124

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
136698
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
12486
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
136698
RN LICENSURE
TN
Enumeration date
10/28/2006
Last updated
02/06/2019
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