Provider Demographics
NPI:1750546552
Name:LAM, TINH HUE (CRNA)
Entity type:Individual
Prefix:
First Name:TINH
Middle Name:HUE
Last Name:LAM
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 2930
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-2930
Mailing Address - Country:US
Mailing Address - Phone:423-892-5602
Mailing Address - Fax:855-630-1300
Practice Address - Street 1:975 E . THIRD STREET
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2147
Practice Address - Country:US
Practice Address - Phone:423-778-7608
Practice Address - Fax:423-778-2360
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN13575367500000X
TNRN143736163W00000X
GARN177468163W00000X
KY3005846367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4187242OtherBLUE CROSS BLUE SHIELD TN
AL108573Medicaid
KY7100065010Medicaid
TN1511654Medicaid
NC8053504Medicaid
GAN455527OtherWELLCARE GA
GA715186013AMedicaid