MEDICARE: KRISTEN C. MUMME CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	CRNA1160	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518280064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN C. MUMME CRNA

Provider Business Mailing Address
First Line	:	1850 N CENTRAL AVE
Second Line	:	STE 1600
City	:	PHOENIX
State	:	AZ
Zip	:	85004-4633
Country	:	US
Telephone Number	:	602-262-8900
Fax Number	:	602-262-8900

Provider Business Practice Location Address
First Line	:	9926 DAISY AVE
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4721
Country	:	US
Telephone Number	:	561-414-7233
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2010
Last Update Date	:	04/26/2016

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