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NPI 1700696671

NPI 1700696671 : COREEN MARIA MOSER SCHAAFSMA CRNA : LEXINGTON, KY

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General NPI Number Information
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    NPI Number           |    1700696671
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    Entity Type          |    Individual 
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    Provider Name        |    COREEN MARIA MOSER SCHAAFSMA CRNA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/13/2025
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    Last Update Date     |    08/19/2025
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Provider Practice Location Address
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    Address Line         |    800 ROSE ST 
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    City                 |    LEXINGTON
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    State                |    KY
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    Zip                  |    40536-7001
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    Country              |    US
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    Telephone            |    859-323-5956
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    Fax                  |    859-323-1080
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Provider Business Mailing Address
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    Address Line         |    1570 CLINTONVILLE RD 
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    City                 |    PARIS
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    State                |    KY
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    Zip                  |    40361-9179
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    Country              |    US
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    Telephone            |    540-809-9674
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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       |    4034086
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    License Number State |    KY
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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       |    RN215249
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    License Number State |    AZ
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