Individual
VIRGINIA LEE KERNODLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6005 PARK AVE, SUITE 905 B, MEMPHIS, TN 38119-5202
(901) 682-2872
Mailing address
3871 PRESCOTT RD, MEMPHIS, TN 38118-5959
(901) 494-4506
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN133007
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4144051
BLUE CROSS
TN
Enumeration date
10/16/2006
Last updated
06/26/2013
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