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General NPI Number Information
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NPI Number | 1790884575
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Entity Type | Individual
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Provider Name | BARBARA ANN BISTRAM CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 09/25/2017
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Provider Practice Location Address
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Address Line | 1 TAMPA GENERAL CIR SUITE A327
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City | TAMPA
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State | FL
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Zip | 33606-3571
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Country | US
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Telephone | 813-844-4396
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Fax | 813-844-4972
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Provider Business Mailing Address
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Address Line | 9200 W WISCONSIN AVE
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City | MILWAUKEE
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State | WI
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Zip | 53226-3522
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Country | US
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Telephone | 414-805-5951
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Fax | 414-805-4870
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 1757
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License Number State | MN
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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 | R0901280
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License Number State | MN
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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 | ARNP9264662
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 145974030
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License Number State | WI
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