Basic Information
| Provider Information | |||||||||
| NPI: | 1235406869 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AMATO | ||||||||
| FirstName: | CLARE | ||||||||
| MiddleName: | R. | ||||||||
| NamePrefix: | |||||||||
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| Credential: | CRNA | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | CROWLEY | ||||||||
| OtherFirstName: | CLARE | ||||||||
| OtherMiddleName: | |||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 4401 MASTHEAD ST NE | ||||||||
| Address2: | #120 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871094497 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052437729 | ||||||||
| FaxNumber: | 5052434804 | ||||||||
| Practice Location | |||||||||
| Address1: | 4401 MASTHEAD ST NE | ||||||||
| Address2: | #120 | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871094497 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052437729 | ||||||||
| FaxNumber: | 5052434804 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/28/2011 | ||||||||
| LastUpdateDate: | 08/24/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | CRNA-01171 | NM | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.