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NPI Code Detail

MEDICARE: CHRISTINE G CLEAVES CRNA

MEDICARE: CHRISTINE G CLEAVES 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
1363L00000XNurse Practitioner0024167283VA
2364SC0200XCritical Care Medicine Clinical Nurse SpecialistAC000646MD
3367500000XCertified Registered Nurse AnesthetistAC001391MD
4367500000XCertified Registered Nurse Anesthetist26NJ00879900NJ
5367500000XCertified Registered Nurse Anesthetist105763WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649364159
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE G CLEAVES CRNA
Provider Business Mailing Address
First Line : 1 FEDERAL ST # 200
Second Line :
City : CAMDEN
State : NJ
Zip : 08103-1088
Country : US
Telephone Number : 856-356-4924
Fax Number :
Provider Business Practice Location Address
First Line : 2500 HOSPITAL DR
Second Line :
City : MARTINSBURG
State : WV
Zip : 25401-3402
Country : US
Telephone Number : 304-264-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2006
Last Update Date : 10/26/2023

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