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NPI Code Detail

MEDICARE: MS. ELLEN CLAIRE KNUDSEN CRNA

MEDICARE: MS. ELLEN CLAIRE KNUDSEN 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 AnesthetistARNP1356842FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1497791461
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELLEN CLAIRE KNUDSEN CRNA
Provider Business Mailing Address
First Line : PO BOX 918025
Second Line :
City : ORLANDO
State : FL
Zip : 32891-8025
Country : US
Telephone Number : 352-265-0077
Fax Number :
Provider Business Practice Location Address
First Line : 1600 SW ARCHER RD
Second Line :
City : GAINESVILLE
State : FL
Zip : 32610-3003
Country : US
Telephone Number : 352-392-3441
Fax Number : 352-392-7029
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2006
Last Update Date : 03/06/2008

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