Tate Crockett, Holly C

Tate Crockett, Holly C is an individual health care provider with primary practice located at 110 29Th Ave N , Nashville TN 37203-1401. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Tate Crockett, Holly C can be contacted via phone (615) 327-4304.

Contact Information

Primary practice address
110 29Th Ave N Nashville TN 37203-1401
Phone: (615) 327-4304
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 73958 Tennessee

Profile Details

NPI number 1760452932
LBN Legal business name Tate Crockett, Holly C
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated Sep 24th, 2007 - about 17 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 1760452932 NPPES
Tennessee Other 4120866 BCBS
Tennessee MEDICAID 74011503 BCBS
Tennessee MEDICAID 3636169 BCBS

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