| Ms Susan R St John, CRNA | |
|
787 D Sain Rd, Manchester, TN 37355-3940 | |
| (931) 409-1238 | |
| Not Available |
| Full Name | Ms Susan R St John |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 787 D Sain Rd, Manchester, Tennessee |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689617334 | NPI | - | NPPES |
| 3624683 | Medicaid | TN | |
| P0009555 | Other | TN | RAILROAD MEDICARE |
| 4061907 | Other | TN | BLUECROSS |
| 7100387060 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 46243 (Tennessee) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | 3009223 (Kentucky) | Secondary |
| Entity Name | Anesthesia Care Of Tullahoma Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902849607 PECOS PAC ID: 4385558543 Enrollment ID: O20031113000214 |
| Entity Name | Northstar Anesthesia Of Tennessee, Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1821390451 PECOS PAC ID: 6608058086 Enrollment ID: O20110307000153 |
| Entity Name | Coastal Healthcare Resources Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467635128 PECOS PAC ID: 1658283593 Enrollment ID: O20130719000048 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Susan R St John, CRNA 787 D Sain Rd, Manchester, TN 37355-3940 Ph: (931) 409-1238 | Ms Susan R St John, CRNA 787 D Sain Rd, Manchester, TN 37355-3940 Ph: (931) 409-1238 |
Mr. Johnny Michael Mccormick, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1001 Mcarthur Street, United Regional Medical Center, Manchester, TN 37355 Phone: 931-728-3586 Fax: 931-728-6877 | |
Marsha L Marlin, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 481 Interstate Dr, Manchester, TN 37355 Phone: 931-728-5607 Fax: 931-728-8354 |