Basic Information
| Provider Information | |||||||||
| NPI: | 1215261052 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CREMIN | ||||||||
| FirstName: | JENNIFER | ||||||||
| MiddleName: | KURCINA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2173 CENTERVILLE PL | ||||||||
| Address2: | STE A | ||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323088302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8503850144 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1300 MICCOSUKEE RD | ||||||||
| Address2: | |||||||||
| City: | TALLAHASSEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 323085054 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8504311155 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/27/2009 | ||||||||
| LastUpdateDate: | 09/27/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | RN 9181525 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.