Provider Demographics
NPI:1891982427
Name:KRTAUSCH, BAMBI RACHELLE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:BAMBI
Middle Name:RACHELLE
Last Name:KRTAUSCH
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 BLOUNTVILLE BYP
Mailing Address - Street 2:SCHOOL NURSE SUPERVISOR
Mailing Address - City:BLOUNTVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37617-4575
Mailing Address - Country:US
Mailing Address - Phone:423-279-2777
Mailing Address - Fax:
Practice Address - Street 1:2348 HIGHWAY 75
Practice Address - Street 2:
Practice Address - City:BLOUNTVILLE
Practice Address - State:TN
Practice Address - Zip Code:37617-6340
Practice Address - Country:US
Practice Address - Phone:423-354-1550
Practice Address - Fax:423-354-1555
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000080922163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool