Provider Demographics
NPI:1497795256
Name:THORNTON, BUDONNA CAROLE (CRNA)
Entity type:Individual
Prefix:
First Name:BUDONNA
Middle Name:CAROLE
Last Name:THORNTON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:BUDONNA
Other - Middle Name:
Other - Last Name:SWAFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:110 29TH AVE N
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1401
Mailing Address - Country:US
Mailing Address - Phone:615-327-4304
Mailing Address - Fax:615-327-7940
Practice Address - Street 1:110 29TH AVE N
Practice Address - Street 2:SUITE 202
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1401
Practice Address - Country:US
Practice Address - Phone:615-327-4304
Practice Address - Fax:615-327-7940
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN11816367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY74011834OtherKY MEDICAID
TN10071330OtherAMERIGROUP
TN4123255OtherBCBS
TN3636701Medicaid
TN3636701Medicaid