MEDICARE: ANITA M. KNELLER 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	104692	CO

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780622845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANITA M. KNELLER CRNA

Provider Business Mailing Address
First Line	:	9749 HUMMINGBIRD PL
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80125-8894
Country	:	US
Telephone Number	:	303-941-0902
Fax Number	:	303-904-4242

Provider Business Practice Location Address
First Line	:	9749 HUMMINGBIRD PL
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80125-8894
Country	:	US
Telephone Number	:	303-941-0902
Fax Number	:	303-904-4242

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

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	02/22/2011

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