Provider Demographics
NPI:1184817827
Name:CRNA RELIEF PLLC
Entity Type:Organization
Organization Name:CRNA RELIEF PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TREY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:EARLY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA MSN
Authorized Official - Phone:270-846-4616
Mailing Address - Street 1:178 FISHER LN
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42103-9772
Mailing Address - Country:US
Mailing Address - Phone:270-846-4616
Mailing Address - Fax:270-846-4616
Practice Address - Street 1:44 MCCOY AVE
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-2867
Practice Address - Country:US
Practice Address - Phone:270-821-6818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYPENDINGMedicaid
KYPENDINGMedicare PIN