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General NPI Number Information
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NPI Number | 1770135303
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Entity Type | Individual
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Provider Name | AMELIA ELENA SHRADER CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/13/2019
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Last Update Date | 05/18/2025
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Provider Practice Location Address
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Address Line | 200 MEDICAL CENTER DR SW
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City | FORT PAYNE
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State | AL
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Zip | 35968-3458
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Country | US
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Telephone | 256-845-3150
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Fax |
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Provider Business Mailing Address
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Address Line | 638 MEMORIAL DR
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City | RISING FAWN
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State | GA
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Zip | 30738-5126
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Country | US
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Telephone | 423-315-3514
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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 | 1004305
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3-000998
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License Number State | AL
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