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NPI Code Detail

MEDICARE: MS. CHRISTINE MARIE DAKIN CRNA

MEDICARE: MS. CHRISTINE MARIE DAKIN 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 Anesthetist041199744IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5P00365295OTHERILRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13932056OTHERILBCBS OF IL
27210895OTHERILAETNA
3119638OTHERILHEALTH ALLIANCE
4376060OTHERILHEALTHLINK

General Provider Information

NPI Number : 1295727006
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHRISTINE MARIE DAKIN CRNA
Provider Business Mailing Address
First Line : PO BOX 1105
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46206-1105
Country : US
Telephone Number : 618-549-5361
Fax Number : 618-549-5128
Provider Business Practice Location Address
First Line : 2601 W MAIN ST
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-1031
Country : US
Telephone Number : 618-549-5361
Fax Number : 618-549-5128
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2005
Last Update Date : 10/08/2009

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