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NPI Code Detail

MEDICARE: MRS. JENNA DUNDAS DEBRABANT CRNA

MEDICARE:  MRS. JENNA DUNDAS DEBRABANT  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 AnesthetistCOA.09245-NAOH

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 : 1558488114
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNA DUNDAS DEBRABANT CRNA
Provider Business Mailing Address
First Line : 200 NORTHLAND BLVD
Second Line : 1ST FLOOR
City : CINCINNATI
State : OH
Zip : 45246-3604
Country : US
Telephone Number : 513-672-3300
Fax Number : 513-672-3323
Provider Business Practice Location Address
First Line : 4700 SMITH RD
Second Line :
City : CINCINNATI
State : OH
Zip : 45212-2787
Country : US
Telephone Number : 513-672-3300
Fax Number : 513-672-3323
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2007
Last Update Date : 04/20/2010

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