Basic Information
| Provider Information | |||||||||
| NPI: | 1881772267 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ESTES | ||||||||
| FirstName: | BRENDA | ||||||||
| MiddleName: | LEE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 456 CARLTON RD | ||||||||
| Address2: | |||||||||
| City: | BRISTOL | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376208709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4236522926 | ||||||||
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| Practice Location | |||||||||
| Address1: | 249 MIDWAY MEDICAL PARK | ||||||||
| Address2: | |||||||||
| City: | BRISTON | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376208709 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4239683033 | ||||||||
| FaxNumber: | 4239683789 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | RN0000071338 | TN | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 367500000X | APN0000010921 | TN | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.