Provider Demographics
NPI:1033147269
Name:GREENWELL, SUZANNA B (MSN-CRNA)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNA
Middle Name:B
Last Name:GREENWELL
Suffix:
Gender:F
Credentials:MSN-CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 291264
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37229-1264
Mailing Address - Country:US
Mailing Address - Phone:615-620-2320
Mailing Address - Fax:615-620-2323
Practice Address - Street 1:175 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:TN
Practice Address - Zip Code:38320-1617
Practice Address - Country:US
Practice Address - Phone:731-593-6300
Practice Address - Fax:615-620-2323
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN71210163W00000X
TNAPN11316367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4129312OtherBC/BS TN - INTEGRATED
TN4232052OtherBC/BS OF TN - SAC
TN3624344Medicaid
TN4243114OtherBC/BS OF TN - SAS
TN4236357OtherBLUE CROSS/BLUE SHIELD
TN103I437888Medicare PIN
TN3624343Medicare PIN
TN4232052OtherBC/BS OF TN - SAC