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General NPI Number Information
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NPI Number | 1710018288
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Entity Type | Individual
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Provider Name | KIMBERLY TANNER SCHOLTEN CRNA
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Gender | Female
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 12/18/2013
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Provider Practice Location Address
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Address Line | 3645 NW 85TH TER
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-5101
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Country | US
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Telephone | 954-980-5823
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Fax |
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Provider Business Mailing Address
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Address Line | 3645 NW 85TH TER
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-5101
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Country | US
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Telephone | 954-980-5823
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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 | RN9225102
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License Number State | FL
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