Earwood, Brent Edward

Earwood, Brent Edward is an individual health care provider with primary practice located at 17C Brentshire Square , Jackson TN 38305-2273. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Earwood, Brent Edward can be contacted via phone (731) 664-1717.

Contact Information

Primary practice address
17C Brentshire Square Jackson TN 38305-2273
Phone: (731) 664-1717
Fax: (731) 664-7114
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X APN09716 Tennessee

Profile Details

NPI number 1487651402
LBN Legal business name Earwood, Brent Edward
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2005
Last updated Jul 7th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487651402 NPPES
Tennessee MEDICAID 3622515
Tennessee MEDICAID 3622511

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