Healthcare Provider Details

I. General information

NPI: 1740226844
Provider Name (Legal Business Name): CHARLENE CURRAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 10/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 S HARBOR CITY BLVD SUITE 540
MELBOURNE FL
32901-5594
US

IV. Provider business mailing address

5920 RIVERSIDE DR
MELBOURNE BEACH FL
32951-3740
US

V. Phone/Fax

Practice location:
  • Phone: 321-794-2431
  • Fax:
Mailing address:
  • Phone: 321-794-2431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP2167482
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: