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NPI Code Detail

MEDICARE: DR. CINDERELLA FAMUTIMI CRNA

MEDICARE: DR. CINDERELLA FAMUTIMI CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist157170AZ

General Provider Information

NPI Number : 1154289007
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CINDERELLA FAMUTIMI CRNA
Provider Business Mailing Address
First Line : 19635 N CAVE CREEK RD APT 269
Second Line :
City : PHOENIX
State : AZ
Zip : 85024-1875
Country : US
Telephone Number : 909-647-7380
Fax Number :
Provider Business Practice Location Address
First Line : 101 CIVIC CENTER LN
Second Line :
City : LAKE HAVASU CITY
State : AZ
Zip : 86403-5607
Country : US
Telephone Number : 928-855-8185
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2026
Last Update Date : 01/12/2026

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