Teagan Trent, | |
6965 Cumberland Gap Pkwy, Harrogate, TN 37752-8245 | |
(423) 869-3611 | |
Not Available |
Full Name | Teagan Trent |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 6965 Cumberland Gap Pkwy, Harrogate, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1558018127 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 238593 (Tennessee) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 35656 (Tennessee) | Primary |
Entity Name | Anesthesia Medical Group, P.c. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215932413 PECOS PAC ID: 6901702307 Enrollment ID: O20031208000822 |
Mailing Address | Practice Location Address |
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Teagan Trent, 206 Rogan Rd, Rogersville, TN 37857-3626 Ph: (423) 923-2852 | Teagan Trent, 6965 Cumberland Gap Pkwy, Harrogate, TN 37752-8245 Ph: (423) 869-3611 |
Alec Wiscombe, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6965 Cumberland Gap Parkway, Harrogate, TN 37752 Phone: 423-869-3611 | |
Aneesa Ennab, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6965 Cumberland Gap Pkwy, Harrogate, TN 37752 Phone: 423-869-6324 | |
Joshua O Leatherwood, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6965 Cumberland Gap Pkwy, Harrogate, TN 37752 Phone: 865-309-0746 | |
Caroline Kincaid, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6965 Cumberland Gap Pkwy, Harrogate, TN 37752 Phone: 423-869-3611 |