Healthcare Provider Details

I. General information

NPI: 1770869273
Provider Name (Legal Business Name): CHRISTINA RENE GARDNER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA RENE HEARN CRNA

II. Dates (important events)

Enumeration Date: 10/27/2011
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 13TH ST SW STE 200
LARGO FL
33770-3127
US

IV. Provider business mailing address

PO BOX 633
LARGO FL
33779-0633
US

V. Phone/Fax

Practice location:
  • Phone: 727-450-3030
  • Fax: 727-450-3031
Mailing address:
  • Phone: 727-450-3030
  • Fax: 727-450-3031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11027731
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: