MEDICARE: CHRISTINE ESTHER FIELDS 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	066282	MO
2	367500000X	Certified Registered Nurse Anesthetist	209003637	IL

General Provider Information

NPI Number	:	1982641023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE ESTHER FIELDS CRNA

Provider Business Mailing Address
First Line	:	744 S WEBSTER AVE
Second Line	:
City	:	GREEN BAY
State	:	WI
Zip	:	54301-3505
Country	:	US
Telephone Number	:	920-445-7226
Fax Number	:	920-445-7229

Provider Business Practice Location Address
First Line	:	4421 DEER VALLEY DR
Second Line	:
City	:	FLORISSANT
State	:	MO
Zip	:	63034-1730
Country	:	US
Telephone Number	:	314-355-6227
Fax Number	:	314-355-6227

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	04/06/2016

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