Healthcare Provider Details

I. General information

NPI: 1104161033
Provider Name (Legal Business Name): CAITANYA NALINI TURNER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2012
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 WALLACE BLVD
AMARILLO TX
79106-1799
US

IV. Provider business mailing address

PO BOX 50667
AMARILLO TX
79159-0667
US

V. Phone/Fax

Practice location:
  • Phone: 806-212-2000
  • Fax: 781-407-0998
Mailing address:
  • Phone: 855-565-6705
  • Fax: 302-733-0854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number49304
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2271796
License Number StateMA
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP128043
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: