Gary L Collins, CRNA

Individual provider Active NPI Certified Registered Nurse Anesthetist · Rogersville, TN

NPI 1043205255 · NPPES record last updated Feb 29, 2008

Key facts

NPI
1043205255
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
RN0000053813 (TN)
Practice address
851 Locust St
Rogersville, TN 37857-2407
Phone
(423) 921-7000
Fax
(423) 224-3258
NPI assigned
Sep 14, 2005
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
9137TNMDPharmacist
RN0000053813TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Deercreek Anesthesia Consultants PLLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Hamblen Anesthesia PC Nurse Anesthetist, Certified Registered Past
since Mar 13, 1995
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN0000053813 TN Yes

Addresses

Primary practice location

851 Locust St
Rogersville, TN 37857-2407

Mailing address

999 Executive Park Blvd
Suite 201
Kingsport, TN 37660-4632
Phone (423) 224-3250

Other identifiers

IdentifierTypeStateIssuer
3602591MedicaidTN
3050981OtherTNBCBS

Other providers in Rogersville, TN

All providers in Rogersville, TN · Certified Registered Nurse Anesthetist in Tennessee

Sources for this page

Verify at the official NPI Registry.