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NPI Code Detail

MEDICARE: A KATHLEEN NELSON CRNA

MEDICARE: A KATHLEEN NELSON 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 AnesthetistARNP 1454572FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G0616OTHERBCBS

General Provider Information

NPI Number : 1881685212
Entity Type Code : Individual
Provider Name (Legal Business Name) : A KATHLEEN NELSON CRNA
Provider Business Mailing Address
First Line : 3949 EVANS AVE
Second Line : STE 102
City : FORT MYERS
State : FL
Zip : 33901-9335
Country : US
Telephone Number : 239-939-2622
Fax Number : 239-939-0151
Provider Business Practice Location Address
First Line : 3949 EVANS AVE
Second Line : STE 102
City : FORT MYERS
State : FL
Zip : 33901-9335
Country : US
Telephone Number : 239-939-2622
Fax Number : 239-939-0151
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2005
Last Update Date : 04/09/2008

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Directions to “ A KATHLEEN NELSON CRNA” Practice Location

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