Healthcare Provider Details

I. General information

NPI: 1770756652
Provider Name (Legal Business Name): BARBARA ANN CHALKER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 10/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 HARROUN RD
SYLVANIA OH
43560-2168
US

IV. Provider business mailing address

213 RAINBOW DR # 11333
LIVINGSTON TX
77399-2013
US

V. Phone/Fax

Practice location:
  • Phone: 419-824-1716
  • Fax:
Mailing address:
  • Phone: 956-792-4056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number079519
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: