Provider Demographics
NPI:1790761427
Name:AUBERSON, JACQUELYNNE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:JACQUELYNNE
Middle Name:
Last Name:AUBERSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:JACQUELYNNE
Other - Middle Name:
Other - Last Name:HUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1310 24TH AVE S
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-2637
Mailing Address - Country:US
Mailing Address - Phone:615-873-7003
Mailing Address - Fax:615-873-7757
Practice Address - Street 1:1310 24TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2637
Practice Address - Country:US
Practice Address - Phone:615-873-7003
Practice Address - Fax:615-873-7757
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10754367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered