Provider Demographics
NPI:1376733568
Name:ROSS, LORI B (CRNA)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:B
Last Name:ROSS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:B
Other - Last Name:KITTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 15010
Mailing Address - Street 2:CHILDREN'S ANESTHESIOLOGISTS, PC
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37901-5010
Mailing Address - Country:US
Mailing Address - Phone:865-541-8485
Mailing Address - Fax:865-541-8727
Practice Address - Street 1:2018 W CLINCH AVE
Practice Address - Street 2:CHILDREN'S ANESTHESIOLOGISTS, PC
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2301
Practice Address - Country:US
Practice Address - Phone:865-541-8485
Practice Address - Fax:865-541-8727
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106723367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1296212962OtherAPN LICENSE FOR CRNA
TN106723OtherRN LICENSE