Healthcare Provider Details

I. General information

NPI: 1568413581
Provider Name (Legal Business Name): ELAINE J GARRED CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELAINE J EDWARDS CRNA

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 HOSPITAL AVE
DU BOIS PA
15801-1440
US

IV. Provider business mailing address

100 HOSPITAL AVE
DU BOIS PA
15801-1440
US

V. Phone/Fax

Practice location:
  • Phone: 814-375-3286
  • Fax: 814-375-3384
Mailing address:
  • Phone: 814-375-4200
  • Fax: 814-375-4232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN322996L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN242618
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: