Provider Demographics
NPI:1679804678
Name:TODD, OLNEY N IV (CRNA)
Entity Type:Individual
Prefix:MR
First Name:OLNEY
Middle Name:N
Last Name:TODD
Suffix:IV
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 1:154 CUDE LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-2202
Mailing Address - Country:US
Mailing Address - Phone:615-865-6268
Mailing Address - Fax:615-868-7378
Practice Address - Street 1:4230 HARDING PIKE STE 435
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-4900
Practice Address - Country:US
Practice Address - Phone:615-385-3704
Practice Address - Fax:615-292-1321
Is Sole Proprietor?:No
Enumeration Date:2010-01-15
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN82969367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered