Provider Demographics
NPI:1013298462
Name:GARNER, AMY T (CRNA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:T
Last Name:GARNER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:T
Other - Last Name:ALRED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 3549
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-0549
Mailing Address - Country:US
Mailing Address - Phone:423-698-3309
Mailing Address - Fax:423-624-6355
Practice Address - Street 1:2341 MCCALLIE AVE
Practice Address - Street 2:SUITE 402
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-3239
Practice Address - Country:US
Practice Address - Phone:423-698-3309
Practice Address - Fax:423-624-6355
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN114419367500000X
TNAPN16058367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003113733CMedicaid
TNP01186501OtherRAILROAD MEDICARE
TN4345715OtherBCBS OF TN
GA003113733AMedicaid
TN1525882Medicaid
GA003113733BMedicaid
GA003113733DMedicaid
TN4306569OtherBC BS OF TN
TN103I438810Medicare PIN
GA003113733BMedicaid