Provider Demographics
NPI:1750446621
Name:WEBB, CARL DAVID (CRNA)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:DAVID
Last Name:WEBB
Suffix:
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 1:260 HENDRIX RD
Mailing Address - Street 2:
Mailing Address - City:DOWELLTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37059-2139
Mailing Address - Country:US
Mailing Address - Phone:615-597-6080
Mailing Address - Fax:
Practice Address - Street 1:260 HENDRIX RD
Practice Address - Street 2:
Practice Address - City:DOWELLTOWN
Practice Address - State:TN
Practice Address - Zip Code:37059-2139
Practice Address - Country:US
Practice Address - Phone:615-597-6080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000098797367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered