Provider Demographics
NPI:1639351737
Name:CALVASINA, TAMMY SIMPSON (CRNA)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:SIMPSON
Last Name:CALVASINA
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 1:3901 WHEELERS RUN CV
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38135-1975
Mailing Address - Country:US
Mailing Address - Phone:901-212-6344
Mailing Address - Fax:
Practice Address - Street 1:7111 FAIRWAY DR STE 450
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-4200
Practice Address - Country:US
Practice Address - Phone:865-380-8376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-29
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6815363LF0000X, 367500000X
FLARNP9490618367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily