Provider Demographics
NPI:1922072990
Name:GUINN, DANIEL KRIS (CRNA)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:KRIS
Last Name:GUINN
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:PO BOX 1308
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37662-1308
Mailing Address - Country:US
Mailing Address - Phone:423-224-3460
Mailing Address - Fax:423-224-3465
Practice Address - Street 1:135 W RAVINE
Practice Address - Street 2:SUITE 5-B
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-3847
Practice Address - Country:US
Practice Address - Phone:423-224-3460
Practice Address - Fax:423-224-3465
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11656367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3635362Medicaid
TN0100OtherJOHN DEERE
VI010229715Medicaid
4115746OtherBLUE CROSS OF TN
00013859OtherNHC CARE ADMINISTRATORS
186618OtherANTHEM BCBS
186618OtherANTHEM BCBS
TN0100OtherJOHN DEERE