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General NPI Number Information
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NPI Number | 1770937005
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Entity Type | Individual
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Provider Name | ELIZABETH ANN CHERUKU CRNA
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Gender | Female
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Dates
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Enumeration Date | 04/23/2016
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Last Update Date | 01/03/2022
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Provider Practice Location Address
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Address Line | 4150 V ST STE 1200
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City | SACRAMENTO
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State | CA
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Zip | 95817-1460
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Country | US
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Telephone | 915-734-5028
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Fax |
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Provider Business Mailing Address
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Address Line | 4150 V ST STE 1200
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City | SACRAMENTO
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State | CA
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Zip | 95817-1460
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Country | US
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Telephone | 915-734-5028
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 360931
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License Number State | OH
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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 | 285564
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 95000996
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License Number State | CA
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