Provider Demographics
NPI:1518901305
Name:ELAM, LYNDA JANE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:LYNDA
Middle Name:JANE
Last Name:ELAM
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:LYNDA
Other - Middle Name:JANE
Other - Last Name:HOOTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:110 29TH AVE N
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1401
Mailing Address - Country:US
Mailing Address - Phone:615-327-4304
Mailing Address - Fax:615-327-7940
Practice Address - Street 1:110 29TH AVE N
Practice Address - Street 2:SUITE 202
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1401
Practice Address - Country:US
Practice Address - Phone:615-327-4304
Practice Address - Fax:615-327-7940
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN9221367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY74397043OtherKY MEDICAID
TNP00273611OtherRAILROAD MEDICARE
TN10071320OtherAMERIGROUP
TN3602447Medicaid
TN4102244OtherBCBS
TN4102244OtherBCBS