Healthcare Provider Details

I. General information

NPI: 1194072413
Provider Name (Legal Business Name): RITA L NOLIND APRN, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2012
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17035 HARVEST MOON WAY
BRADENTON FL
34211-2767
US

IV. Provider business mailing address

17035 HARVEST MOON WAY
BRADENTON FL
34211-2767
US

V. Phone/Fax

Practice location:
  • Phone: 941-993-8970
  • Fax:
Mailing address:
  • Phone: 941-993-8970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number12-80711-091
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9378034
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: