Healthcare Provider Details

I. General information

NPI: 1487696746
Provider Name (Legal Business Name): MARLA CHIARELLI CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 10/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 N CUMMINGS DR
MIDDLETOWN DE
19709-1665
US

IV. Provider business mailing address

32 N CUMMINGS DR
MIDDLETOWN DE
19709-1665
US

V. Phone/Fax

Practice location:
  • Phone: 609-970-6259
  • Fax:
Mailing address:
  • Phone: 609-970-6259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberL1-0029218
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: