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General NPI Number Information
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NPI Number | 1255220935
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Entity Type | Individual
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Provider Name | KARL EMMANUEL ANTOINE DNP, CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 620 JOHN PAUL JONES CIR
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City | PORTSMOUTH
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State | VA
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Zip | 23708-2111
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Country | US
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Telephone | 757-953-5008
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Fax |
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Provider Business Mailing Address
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Address Line | 620 JOHN PAUL JONES CIR
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City | PORTSMOUTH
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State | VA
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Zip | 23708-2197
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Country | US
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Telephone | 757-953-3228
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 11040048
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0024194100
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9460329
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License Number State | FL
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