Healthcare Provider Details

I. General information

NPI: 1760526800
Provider Name (Legal Business Name): DEBRA BLISH CRNAP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3309 SW 34TH CIR STE 101
OCALA FL
34474-3311
US

IV. Provider business mailing address

23610 NE 154PL
FORT MCCOY FL
32134
US

V. Phone/Fax

Practice location:
  • Phone: 352-237-0509
  • Fax:
Mailing address:
  • Phone: 352-685-2247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9194722
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: