Provider Demographics
NPI:1003815978
Name:HANDY, MISTY COGGINS (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:MISTY
Middle Name:COGGINS
Last Name:HANDY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MISTY
Other - Middle Name:
Other - Last Name:COGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 29TH AVE N
Mailing Address - Street 2:STE 202
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1401
Mailing Address - Country:US
Mailing Address - Phone:615-327-4304
Mailing Address - Fax:
Practice Address - Street 1:110 29TH AVE N
Practice Address - Street 2:STE 202
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1401
Practice Address - Country:US
Practice Address - Phone:615-327-4304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN055130367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009912325Medicaid
TN4049479OtherBCBS NUMBER
KY74005448Medicaid
TN3631788Medicaid
TN3631788Medicaid