MEDICARE: TERESA A KINSEY 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	ARNP 1801932	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00807037	OTHER	FL	RAILROAD MEDICARE
3	G1880Y	OTHER	FL	MEDICARE-MFAA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	G3830	OTHER	FL	BCBS OF FLORIDA

General Provider Information

NPI Number	:	1659327732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA A KINSEY CRNA

Provider Business Mailing Address
First Line	:	956 NW EGRET CT
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34994-9532
Country	:	US
Telephone Number	:	772-692-9806
Fax Number	:	772-692-1861

Provider Business Practice Location Address
First Line	:	1874 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-5545
Country	:	US
Telephone Number	:	772-336-7676
Fax Number	:	772-668-9034

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	08/02/2011

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Directions to “ TERESA A KINSEY CRNA” Practice Location

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