Provider Demographics
NPI:1134195811
Name:RIDNER, CHRISTY L (CRNA)
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:L
Last Name:RIDNER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6392 LYNN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37341-8987
Mailing Address - Country:US
Mailing Address - Phone:423-315-7056
Mailing Address - Fax:
Practice Address - Street 1:6392 LYNN RD
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:TN
Practice Address - Zip Code:37341-8987
Practice Address - Country:US
Practice Address - Phone:423-315-7056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN122890367500000X
TNRN107209367500000X
TNAPN11758367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4115511OtherBCBS
TN3635849Medicare ID - Type Unspecified