Healthcare Provider Details

I. General information

NPI: 1174662423
Provider Name (Legal Business Name): DONNA R ALLEN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DONNA R ALLEN CRNA,MS

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 04/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1816 WINDSWEPT CIR
DOVER DE
19901-5853
US

IV. Provider business mailing address

35842 TARPON DR
LEWES DE
19958-5048
US

V. Phone/Fax

Practice location:
  • Phone: 302-674-4700
  • Fax:
Mailing address:
  • Phone: 302-245-0699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberL60A00233
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: