Healthcare Provider Details

I. General information

NPI: 1548031156
Provider Name (Legal Business Name): CAROLINE ALYCE KNOLL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2024
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4841 FINLANDIA WAY
CARMICHAEL CA
95608-6219
US

IV. Provider business mailing address

4841 FINLANDIA WAY
CARMICHAEL CA
95608-6219
US

V. Phone/Fax

Practice location:
  • Phone: 916-595-3987
  • Fax:
Mailing address:
  • Phone: 916-595-3987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number95002816
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: