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General NPI Number Information
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NPI Number | 1568666345
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Entity Type | Organization
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Legal Business Name | ROXANE HENKE CRNA, INC
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 03/31/2014
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Provider Practice Location Address
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Address Line | 1240 BURKE RD
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-4415
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Country | US
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Telephone | 410-335-7472
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Fax | 410-335-7472
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Provider Business Mailing Address
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Address Line | 1240 BURKE RD
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-4415
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Country | US
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Telephone | 410-335-7472
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Fax | 410-335-7472
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Authorized Official
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Title or Position | OWNER
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Name | ROXANE LEE HENKE
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Credential | CRN A
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Telephone | 410-335-7472
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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 | R069548
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License Number State | MD
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