Provider Demographics
NPI:1912927732
Name:PAGE, LYNDA L (CRNA)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:L
Last Name:PAGE
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:PO BOX 291264
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37229-1264
Mailing Address - Country:US
Mailing Address - Phone:615-620-2320
Mailing Address - Fax:615-620-2323
Practice Address - Street 1:235 MEDICAL PARK BLVD
Practice Address - Street 2:THE ENDOSCPY CENTER OF BRISTOL
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-7455
Practice Address - Country:US
Practice Address - Phone:615-620-2320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN14132367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP0081827OtherRR MEDICARE - PALMETTO GBA
SCAN0597Medicaid
TN4248423OtherBLUE CROSS/BLUE SHIELD OF TN
TN1515519Medicaid
SCAN0597Medicaid
TN4248423OtherBLUE CROSS/BLUE SHIELD OF TN