Provider Demographics
NPI:1407818164
Name:BAYER, CYNTHIA ANN (CRNA)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:ANN
Last Name:BAYER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11133 WINDWARD DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-4049
Mailing Address - Country:US
Mailing Address - Phone:865-806-4948
Mailing Address - Fax:
Practice Address - Street 1:11133 WINDWARD DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-4049
Practice Address - Country:US
Practice Address - Phone:865-806-4948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-06
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN76389367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3621177Medicaid
TN100022253OtherPHP TENNCARE
TNP00178404OtherTRAVELERS MEDICARE
TN4088305OtherBLUE CROSS
TN4088305OtherBLUECARE
TN3621177Medicare ID - Type Unspecified
TN3621177Medicaid