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General NPI Number Information
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NPI Number | 1477816247
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Entity Type | Individual
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Provider Name | AUDRIE E. SAFRITHIS CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 11/15/2015
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Provider Practice Location Address
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Address Line | 301 W HOMER ST
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City | MICHIGAN CITY
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State | IN
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Zip | 46360-4358
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Country | US
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Telephone | 219-879-8511
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Fax |
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Provider Business Mailing Address
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Address Line | 235 WEST VANBUREN STREET UNIT 3016
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City | CHICAGO
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State | IL
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Zip | 60607-3939
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Country | US
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Telephone | 312-213-3755
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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 | 209.009508041.313418
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License Number State | IL
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