Healthcare Provider Details

I. General information

NPI: 1811983554
Provider Name (Legal Business Name): NORMA ROSADO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 09/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5959 SHALLOWFORD RD SUITE 559
CHATTANOOGA TN
37421-2285
US

IV. Provider business mailing address

14327 PEACOCK SPRINGS TRL
ORLANDO FL
32828-7789
US

V. Phone/Fax

Practice location:
  • Phone: 423-424-3867
  • Fax:
Mailing address:
  • Phone: 407-360-9804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374T00000X
TaxonomyReligious Nonmedical Nursing Personnel
License NumberARNP2771382
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: