MEDICARE: MS. CARMELITA M DAY 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	123467	AL
2	367500000X	Certified Registered Nurse Anesthetist	ARNP9245967	FL

General Provider Information

NPI Number	:	1710094982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CARMELITA M DAY CRNA

Provider Business Mailing Address
First Line	:	11345 BROOKLYN RD
Second Line	:
City	:	ANDALUSIA
State	:	AL
Zip	:	36421-6407
Country	:	US
Telephone Number	:	334-427-1021
Fax Number	:	334-427-3021

Provider Business Practice Location Address
First Line	:	11345 BROOKLYN RD
Second Line	:
City	:	ANDALUSIA
State	:	AL
Zip	:	36421-6407
Country	:	US
Telephone Number	:	334-427-1021
Fax Number	:	334-427-3021

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

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	03/16/2009

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