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General NPI Number Information
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NPI Number | 1427010180
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Entity Type | Individual
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Provider Name | RENETTE BARDIN CRNA
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Gender | Female
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 875 8TH ST NE
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City | MASSILLON
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State | OH
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Zip | 44646-8503
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Country | US
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Telephone | 330-832-8761
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 235022
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City | MONTGOMERY
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State | AL
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Zip | 36123-5022
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Country | US
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Telephone |
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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 | RN202582
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License Number State | OH
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