Healthcare Provider Details

I. General information

NPI: 1699558296
Provider Name (Legal Business Name): DANIELLE ESCHETE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE BRAIWICK

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 08/16/2023
Certification Date: 08/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MOBILE INFIRMARY CIR
MOBILE AL
36607-3513
US

IV. Provider business mailing address

51 N INGLESIDE ST
FAIRHOPE AL
36532-2917
US

V. Phone/Fax

Practice location:
  • Phone: 985-373-5220
  • Fax:
Mailing address:
  • Phone: 985-373-5220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-142795
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: