MEDICARE: DR. DEANNA LYN KLINE CRNA, D.N.P.

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	1985302	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	G1962	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972582674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEANNA LYN KLINE CRNA, D.N.P.

Provider Business Mailing Address
First Line	:	26714 WINGED ELM DR
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-7762
Country	:	US
Telephone Number	:	813-948-7776
Fax Number	:	813-857-9555

Provider Business Practice Location Address
First Line	:	26714 WINGED ELM DR
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33543-7762
Country	:	US
Telephone Number	:	813-948-7776
Fax Number	:	813-857-9555

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

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	03/30/2022

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