Basic Information
| Provider Information | |||||||||
| NPI: | 1821140310 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PREFERRED ANESTHESIA, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | TERRI L BROTHERS | ||||||||
| OtherOrganizationType: | 5 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 16068 | ||||||||
| Address2: | |||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272616068 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368824615 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 22024 RHEA COUNTY HWY | ||||||||
| Address2: | |||||||||
| City: | SPRING CITY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373815243 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4233656222 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | BROTHERS | ||||||||
| AuthorizedOfficialFirstName: | TERRI | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4238433901 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | CRNA | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Nursing Service Providers | Registered Nurse | Pain Management |
No ID Information.