Healthcare Provider Details

I. General information

NPI: 1891757159
Provider Name (Legal Business Name): KATHERINE L LANPHIER REANEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE L LANPHIER CRNA

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 04/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1613 HARRISON PKWY #200
SUNRISE FL
33323-2853
US

IV. Provider business mailing address

PO BOX 452015
SUNRISE FL
33345-2015
US

V. Phone/Fax

Practice location:
  • Phone: 954-838-2371
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP01611
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: