MEDICARE: SETH ENTREKIN 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
1	367500000X	Certified Registered Nurse Anesthetist	1-130732	AL
2	367500000X	Certified Registered Nurse Anesthetist	6585	NC

General Provider Information

NPI Number	:	1528651528
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SETH ENTREKIN CRNA

Provider Business Mailing Address
First Line	:	200 SWINDALL CIR
Second Line	:
City	:	RAINBOW CITY
State	:	AL
Zip	:	35906-7730
Country	:	US
Telephone Number	:	205-876-5545
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 SWINDALL CIR
Second Line	:
City	:	RAINBOW CITY
State	:	AL
Zip	:	35906-7730
Country	:	US
Telephone Number	:	205-876-5545
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2021
Last Update Date	:	07/12/2024

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