Basic Information
| Provider Information | |||||||||
| NPI: | 1285972158 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CHIRLIN | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | JOANNE | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 MEDICAL CENTER DR | ||||||||
| Address2: | ANESTHESIA DEPT | ||||||||
| City: | MIDDLETOWN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134242111 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9507 BENCHMARK LN | ||||||||
| Address2: | |||||||||
| City: | BLUE ASH | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452426005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134777391 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/28/2013 | ||||||||
| LastUpdateDate: | 08/10/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 344094 | OH | N | Nursing Service Providers | Registered Nurse | 163W00000X | 766634 | CA | N | Nursing Service Providers | Registered Nurse | 163W00000X | 668133 | NY | N | Nursing Service Providers | Registered Nurse | 367500000X | 19086 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.