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General NPI Number Information
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NPI Number | 1598337594
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Entity Type | Individual
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Provider Name | MICHAEL ANN JURGENS SRNA
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Gender | Female
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Dates
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Enumeration Date | 07/11/2021
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Last Update Date | 07/11/2021
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Provider Practice Location Address
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Address Line | 234 GOODMAN ST
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City | CINCINNATI
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State | OH
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Zip | 45219-2364
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Country | US
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Telephone | 513-584-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 923 MONROE ST
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City | NEWPORT
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State | KY
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Zip | 41071-2246
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Country | US
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Telephone | 859-391-8501
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN.408339
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | RN.408339
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License Number State | OH
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