Provider Demographics
NPI:1215923693
Name:SCHRIMPE, CHARLA L (CRNA)
Entity type:Individual
Prefix:
First Name:CHARLA
Middle Name:L
Last Name:SCHRIMPE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CHARLA
Other - Middle Name:L
Other - Last Name:SCHRIMPE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:122 GERIS WAY
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-8313
Mailing Address - Country:US
Mailing Address - Phone:615-444-4571
Mailing Address - Fax:
Practice Address - Street 1:122 GERIS WAY
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-8313
Practice Address - Country:US
Practice Address - Phone:615-444-4571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-21
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN070511367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009947655Medicaid
TN4077095OtherBCBS NUMBER
KY74007782Medicaid
TN3633328Medicaid
TN3633325Medicare PIN