Healthcare Provider Details

I. General information

NPI: 1770244139
Provider Name (Legal Business Name): JONATHAN CURRAN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2022
Last Update Date: 04/25/2025
Certification Date: 04/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 N WASHINGTON ST
CHILLICOTHEE MO
64601-2902
US

IV. Provider business mailing address

510 SE 5TH AVE APT 605
FORT LAUDERDALE FL
33301-2994
US

V. Phone/Fax

Practice location:
  • Phone: 660-646-1480
  • Fax:
Mailing address:
  • Phone: 334-596-0616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11017156
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2025010680
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: