Provider Demographics
NPI:1346216199
Name:GERTONSON, STEVEN FREDRICK (CRNA)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:FREDRICK
Last Name:GERTONSON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 BRADBURY RD
Mailing Address - Street 2:
Mailing Address - City:ADAMS
Mailing Address - State:TN
Mailing Address - Zip Code:37010-8901
Mailing Address - Country:US
Mailing Address - Phone:931-358-2817
Mailing Address - Fax:
Practice Address - Street 1:1950 BRADBURY RD
Practice Address - Street 2:
Practice Address - City:ADAMS
Practice Address - State:TN
Practice Address - Zip Code:37010-8901
Practice Address - Country:US
Practice Address - Phone:931-358-2817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000009262367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered