Healthcare Provider Details

I. General information

NPI: 1376874271
Provider Name (Legal Business Name): ELIZABETH R DUMAS CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2010
Last Update Date: 09/26/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3004 ORANGE GROVE
CHRISTIANSTED ST CROIX
00820
UM

IV. Provider business mailing address

PO BOX 3756
KINGSHILL VI
00851-3756
US

V. Phone/Fax

Practice location:
  • Phone: 251-232-7349
  • Fax:
Mailing address:
  • Phone: 251-232-7349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number9262288
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP12538
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: