Healthcare Provider Details

I. General information

NPI: 1346488483
Provider Name (Legal Business Name): KRISTEN DUVENTRE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2009
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 EXETER RD SUITE 210
GERMANTOWN TN
38138-2954
US

IV. Provider business mailing address

7381 18TH ST NE
ST PETERSBURG FL
33702-4760
US

V. Phone/Fax

Practice location:
  • Phone: 901-818-2160
  • Fax: 901-682-9522
Mailing address:
  • Phone: 727-527-0683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCRNA9250685
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9250685
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number18980
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number87038
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number202826
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: