Healthcare Provider Details

I. General information

NPI: 1053329649
Provider Name (Legal Business Name): LAYNE LOWREY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 04/30/2020
Certification Date: 04/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3075 W GULF TO LAKE HWY
LECANTO FL
34461-9228
US

IV. Provider business mailing address

1105 N PALM SPRINGS TER
CRYSTAL RIVER FL
34429-5260
US

V. Phone/Fax

Practice location:
  • Phone: 352-527-0102
  • Fax: 352-527-8863
Mailing address:
  • Phone: 352-586-8362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN1339712
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: