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NPI Code Detail

MEDICARE: STACY RAE SAUERLAND CRNA

MEDICARE: STACY RAE SAUERLAND 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 AnesthetistCOA11295OH
2367500000XCertified Registered Nurse AnesthetistAPRN9478017FL

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 : 1689905101
Entity Type Code : Individual
Provider Name (Legal Business Name) : STACY RAE SAUERLAND CRNA
Provider Business Mailing Address
First Line : 1 WYOMING ST
Second Line :
City : DAYTON
State : OH
Zip : 45409-2722
Country : US
Telephone Number : 937-208-4380
Fax Number : 937-208-3843
Provider Business Practice Location Address
First Line : 10000 SW INNOVATION WAY
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34987-2111
Country : US
Telephone Number : 772-287-5200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2010
Last Update Date : 09/23/2022

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Directions to “ STACY RAE SAUERLAND CRNA” Practice Location

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