Provider Demographics
NPI:1104984921
Name:COVRIG, JANICE L (CRNA)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:L
Last Name:COVRIG
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:L
Other - Last Name:HASSENCAHL LOPES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 2930
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-2930
Mailing Address - Country:US
Mailing Address - Phone:423-892-5602
Mailing Address - Fax:423-892-5838
Practice Address - Street 1:975 E. THIRD ST
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-2147
Practice Address - Country:US
Practice Address - Phone:423-602-8400
Practice Address - Fax:423-602-8401
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN67798163W00000X
TNAPN11956367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3049755OtherBLUE CROSS BLUE SHIELD TN
TN430030838OtherRAILROAD MEDICARE
NC8052435Medicaid
GAN358442OtherWELLCARE (GA MEDICAID)
GA000579477AMedicaid
TN1512599Medicaid
AL009807720Medicaid
TN430030838OtherRAILROAD MEDICARE