Healthcare Provider Details

I. General information

NPI: 1558729467
Provider Name (Legal Business Name): KARA RENEE THOMPSON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KARA RENEE OSTEDT CRNA

II. Dates (important events)

Enumeration Date: 02/05/2016
Last Update Date: 10/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 COLONY LAKE LN
SARASOTA FL
34233-3476
US

IV. Provider business mailing address

1261 S TAMIAMI TRL
SARASOTA FL
34239-2219
US

V. Phone/Fax

Practice location:
  • Phone: 608-385-0082
  • Fax:
Mailing address:
  • Phone: 608-385-0082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9266541
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: