Basic Information
| Provider Information | |||||||||
| NPI: | 1689055097 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARB | ||||||||
| FirstName: | STEPHANIE | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 410 N CEDAR BLUFF RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379233623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8653429012 | ||||||||
| FaxNumber: | 8656910843 | ||||||||
| Practice Location | |||||||||
| Address1: | 410 N CEDAR BLUFF RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | KNOXVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 379233623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8653429012 | ||||||||
| FaxNumber: | 8656910843 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2015 | ||||||||
| LastUpdateDate: | 12/11/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 20426 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 163W00000X | 180272 | TN | N | Nursing Service Providers | Registered Nurse |
No ID Information.