Provider Demographics
NPI:1003819772
Name:DEPASS, STEVEN C (CRNA, MS)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:C
Last Name:DEPASS
Suffix:
Gender:M
Credentials:CRNA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:448 QUARRY RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT JULIET
Mailing Address - State:TN
Mailing Address - Zip Code:37122-7903
Mailing Address - Country:US
Mailing Address - Phone:615-453-1089
Mailing Address - Fax:615-453-1089
Practice Address - Street 1:448 QUARRY RD
Practice Address - Street 2:
Practice Address - City:MOUNT JULIET
Practice Address - State:TN
Practice Address - Zip Code:37122-7903
Practice Address - Country:US
Practice Address - Phone:615-453-1089
Practice Address - Fax:615-453-1089
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN74349367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered