Provider Demographics
NPI:1689816365
Name:PRIORITY ANESTHESIA, LLC
Entity Type:Organization
Organization Name:PRIORITY ANESTHESIA, LLC
Other - Org Name:PRIORITY ANESTHESIA PLLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:M
Authorized Official - Last Name:RAY
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:865-696-2906
Mailing Address - Street 1:PO BOX 1003
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:TN
Mailing Address - Zip Code:37748-1003
Mailing Address - Country:US
Mailing Address - Phone:865-590-0993
Mailing Address - Fax:
Practice Address - Street 1:4713 PAPERMILL DR STE 100
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-1924
Practice Address - Country:US
Practice Address - Phone:865-851-7835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2023-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN 10768367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNAPN 10768OtherLICENSE
TNR03397Medicare UPIN