Healthcare Provider Details

I. General information

NPI: 1619608429
Provider Name (Legal Business Name): KAITLYN DAWN YOOK RN-BSN, CRNA, DNAP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2022
Last Update Date: 06/27/2022
Certification Date: 06/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 DON WICKHAM DR
CLERMONT FL
34711-1979
US

IV. Provider business mailing address

3042 PRINCEWOOD DR
MINNEOLA FL
34715-6076
US

V. Phone/Fax

Practice location:
  • Phone: 352-394-4071
  • Fax:
Mailing address:
  • Phone: 518-222-6658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11020282
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: