Healthcare Provider Details

I. General information

NPI: 1497752380
Provider Name (Legal Business Name): CHRISTOPHER ROBEL CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 S HANOVER ST
BALTIMORE MD
21230-4033
US

IV. Provider business mailing address

929 S HANOVER ST
BALTIMORE MD
21230-4033
US

V. Phone/Fax

Practice location:
  • Phone: 443-762-8471
  • Fax: 888-979-6102
Mailing address:
  • Phone: 443-762-8471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR139169
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: