Basic Information
| Provider Information | |||||||||
| NPI: | 1497281653 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | C&E APRN-CRNA ANESTHESIA PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9913 SOUTH MAY AVE | ||||||||
| Address2: | STE C | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731597020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4057030614 | ||||||||
| FaxNumber: | 4057031270 | ||||||||
| Practice Location | |||||||||
| Address1: | 419 W GRAY ST | ||||||||
| Address2: | |||||||||
| City: | NORMAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 730697117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4053297300 | ||||||||
| FaxNumber: | 4053645379 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2017 | ||||||||
| LastUpdateDate: | 05/10/2017 | ||||||||
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| AuthorizedOfficialLastName: | ESTLE | ||||||||
| AuthorizedOfficialFirstName: | EMILY | ||||||||
| AuthorizedOfficialMiddleName: | SUZANNE | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 4053081735 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | APRN-CRNA | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | R0073283 | OK | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.