Provider Demographics
NPI:1346396306
Name:BORRESEN, BJARNE M (CRNA)
Entity Type:Individual
Prefix:
First Name:BJARNE
Middle Name:M
Last Name:BORRESEN
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:PO BOX 535575
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-5595
Mailing Address - Country:US
Mailing Address - Phone:865-342-8900
Mailing Address - Fax:865-691-0843
Practice Address - Street 1:410 N CEDAR BLUFF RD
Practice Address - Street 2:SUITE 300
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-3623
Practice Address - Country:US
Practice Address - Phone:423-698-3309
Practice Address - Fax:423-624-6355
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN12376367500000X
TNRN132294367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4144907OtherBCBS OF TN
GA209650629CMedicaid
P00390322OtherRAILROAD MEDICARE
GA209650629DMedicaid
TN3638378Medicaid
GA209650629BMedicaid
GA209650629AMedicaid
GA209650629EMedicaid
TN4144907OtherBCBS OF TN