Provider Demographics
NPI:1528049574
Name:CABRON, ANYA (CRNA)
Entity type:Individual
Prefix:
First Name:ANYA
Middle Name:
Last Name:CABRON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 S BROWNS LN
Mailing Address - Street 2:UNIT 2402
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-7474
Mailing Address - Country:US
Mailing Address - Phone:615-451-1112
Mailing Address - Fax:
Practice Address - Street 1:825 S BROWNS LN
Practice Address - Street 2:UNIT 2402
Practice Address - City:GALLATIN
Practice Address - State:TN
Practice Address - Zip Code:37066-7474
Practice Address - Country:US
Practice Address - Phone:615-451-1112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR28853367500000X
TN97281163W00000X
TN40068367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCP00605011OtherRAILROAD MEDICARE
NC8053244Medicaid
NC8053244Medicaid