Provider Demographics
NPI:1942444054
Name:CROCKETT, CHRISTY JOHNSON (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTY
Middle Name:JOHNSON
Last Name:CROCKETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:LEE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:615-936-0023
Mailing Address - Fax:615-936-4294
Practice Address - Street 1:2200 CHILDRENS WAY
Practice Address - Street 2:ROOM 3116
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0005
Practice Address - Country:US
Practice Address - Phone:615-936-0023
Practice Address - Fax:615-936-4294
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-02377207L00000X
TNMD49694207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology