Healthcare Provider Details

I. General information

NPI: 1952471419
Provider Name (Legal Business Name): DIANE KRASNA CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 CROSSROADS DR
OWINGS MILLS MD
21117-5421
US

IV. Provider business mailing address

PO BOX 32550
PIKESVILLE MD
21282-2550
US

V. Phone/Fax

Practice location:
  • Phone: 908-653-9399
  • Fax:
Mailing address:
  • Phone: 410-356-0300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR117721
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: