Healthcare Provider Details

I. General information

NPI: 1619617172
Provider Name (Legal Business Name): CIANA J'NAE HARDY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CIANA CRAWFORD RN

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST
LEXINGTON KY
40536-1600
US

IV. Provider business mailing address

100 ANGUS E PEYTON DR
SOUTH CHARLESTON WV
25303-1600
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-5956
  • Fax: 859-323-1080
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number100274
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number4020020
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: