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NPI Code Detail

MEDICARE: DEXTER MICHAEL MITCHELL CRNA

MEDICARE: DEXTER MICHAEL MITCHELL 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 Anesthetist0024184163VA
2367500000XCertified Registered Nurse AnesthetistAPRN2880602FL
3367500000XCertified Registered Nurse AnesthetistARNP2880602FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G00RWOTHERFLBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992098669
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEXTER MICHAEL MITCHELL CRNA
Provider Business Mailing Address
First Line : 9306 BLUEBERRY ASH CIR
Second Line :
City : RIVERVIEW
State : FL
Zip : 33578-8667
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2 BERNARDINE DR
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23602-4404
Country : US
Telephone Number : 757-886-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2011
Last Update Date : 05/13/2026

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