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NPI Code Detail

MEDICARE: LOREN KRUMBHOLZ CRNA

MEDICARE:   LOREN  KRUMBHOLZ  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
1163W00000XRegistered NurseRN 9265771FL
2367500000XCertified Registered Nurse AnesthetistAPRN9265771FL

Other Identifiers

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

General Provider Information

NPI Number : 1841614401
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOREN KRUMBHOLZ CRNA
Provider Business Mailing Address
First Line : 1500 RICARDO AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-6845
Country : US
Telephone Number : 239-443-8070
Fax Number :
Provider Business Practice Location Address
First Line : 1500 RICARDO AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-6845
Country : US
Telephone Number : 239-443-8070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2014
Last Update Date : 05/29/2019

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