Healthcare Provider Details

I. General information

NPI: 1851379820
Provider Name (Legal Business Name): EMILIE VICTORIA DIGBY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7152 COCO SABAL LANE GULF COAST ENDOSCOPY CENTER SOUTH
FT MYERS FL
33908
US

IV. Provider business mailing address

6171 MID METRO DRIVE UNIT 2
FORT MYERS FL
33912
US

V. Phone/Fax

Practice location:
  • Phone: 239-985-0215
  • Fax:
Mailing address:
  • Phone: 239-278-9955
  • Fax: 239-278-9966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP226102
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: