ROBERT P MOTHERSHEAD CRNA
NPI 1366436933
Nurse Anesthetist, Certified Registered in Johnson City, TN

Q: What is Robert Mothershead's NPI number?

The NPI number for Robert Mothershead is 1366436933. It was assigned to this individual provider in the NPPES registry on September 9, 2005.

Q: What is Robert Mothershead's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Active since September 09, 2005

1009 LARK ST, SUITE 2, JOHNSON CITY, TN 37604(423) 283-0776(423) 283-0549 Get Directions Write a Review

NPPES record last updated: May 15, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Robert P Mothershead Crna NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROBERT P MOTHERSHEAD CRNA (NPI 1366436933) is an individual nurse anesthetist, certified registered in Johnson City, Tennessee, licensed in Tennessee (RN0000054069) and active in the NPI registry since September 2005.

NPPES Registry Identity

NPI1366436933

Entity TypeIndividualMale

Primary Taxonomy367500000X

Provider Legal NameROBERT P MOTHERSHEADCredential: CRNA

Location Address1009 LARK ST, SUITE 2Johnson City, TN 37604-8217

Mailing AddressPo Box 3727Johnson City, TN 37602-3727 · (423) 283-0776 · Fax (423) 283-0549

Phone(423) 283-0776

Fax(423) 283-0549

Sole ProprietorNo

Enumeration DateSeptember 9, 2005

Last NPPES UpdateMay 15, 2014

✔ NPI 1366436933 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367500000X

License✔ Licensed in TN · RN0000054069

Definition

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.

1009 LARK ST, Johnson City, TN 37604

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Other Identifiers 2

Medicaid3602803TN

Medicare PIN3602807TN

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LISA W GREEN CRNA