Gantt, Dian

Gantt, Dian is an individual health care provider with primary practice located at 2000 Brookside Dr , Kingsport TN 37660-4627. 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. Gantt, Dian can be contacted via phone (423) 857-7000.

Contact Information

Primary practice address
2000 Brookside Dr Kingsport TN 37660-4627
Phone: (423) 857-7000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN54210 Tennessee

Profile Details

NPI number 1164471728
LBN Legal business name Gantt, Dian
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 9th, 2006
Last updated Jan 15th, 2008 - about 16 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 1164471728 NPPES
Tennessee MEDICAID 3605025

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