Healthcare Provider Details

I. General information

NPI: 1326645847
Provider Name (Legal Business Name): CAITLIN KRASOWSKI APNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/07/2020
Last Update Date: 10/07/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 HURFFVILLE CROSS KEYS RD
TURNERSVILLE NJ
08012-2453
US

IV. Provider business mailing address

15000 MIDLANTIC DR STE 102
MOUNT LAUREL NJ
08054-1573
US

V. Phone/Fax

Practice location:
  • Phone: 856-829-9345
  • Fax:
Mailing address:
  • Phone: 856-829-9345
  • Fax: 856-829-3605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number131814
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: