Healthcare Provider Details

I. General information

NPI: 1780217752
Provider Name (Legal Business Name): MEGAN ELIZABETH KREUTZJANS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 DIXMYTH AVE
CINCINNATI OH
45220-2475
US

IV. Provider business mailing address

427 RUSSELL ST # 3
COVINGTON KY
41011-1455
US

V. Phone/Fax

Practice location:
  • Phone: 513-862-2432
  • Fax: 513-862-8857
Mailing address:
  • Phone: 859-750-6336
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.020064
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: