Healthcare Provider Details

I. General information

NPI: 1124054028
Provider Name (Legal Business Name): DARLENE GIVENS MILLER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS DARLENE CLARICE GIVENS

II. Dates (important events)

Enumeration Date: 06/23/2006
Last Update Date: 08/26/2020
Certification Date: 08/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 DEEJAY DR
FRANKLIN TN
37064-8234
US

IV. Provider business mailing address

118 DEEJAY DR
FRANKLIN TN
37064-8234
US

V. Phone/Fax

Practice location:
  • Phone: 727-641-8565
  • Fax:
Mailing address:
  • Phone: 727-641-8565
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number695254
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number695254
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0000015859
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number168355
License Number StateAZ
# 5
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP60165774
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: