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General NPI Number Information
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NPI Number | 1427533876
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Entity Type | Individual
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Provider Name | ANGELA MADRID CRNA
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Gender | Female
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Dates
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Enumeration Date | 10/02/2018
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Last Update Date | 09/16/2024
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Provider Practice Location Address
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Address Line | 355 BARD AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10310-1664
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Country | US
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Telephone | 718-818-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 2421 S YELLOWSTONE ST APT 2204
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City | WICHITA
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State | KS
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Zip | 67215-1566
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Country | US
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Telephone | 970-313-6681
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 14-134939-031
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License Number State | KS
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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 | 43-557638-031
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 900143
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License Number State | NY
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