Healthcare Provider Details

I. General information

NPI: 1942279203
Provider Name (Legal Business Name): ANN CASSEL CAIRNS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 05/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29101 HOSPITAL ROAD
LAKE ARROWHEAD CA
92352
US

IV. Provider business mailing address

PO BOX 1810
LAKE ARROWHEAD CA
92352
US

V. Phone/Fax

Practice location:
  • Phone: 909-336-3651
  • Fax:
Mailing address:
  • Phone: 316-281-3700
  • Fax: 316-282-4322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number997
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: