1447690250 NPI number — EMILY E DENK CRNA

Table of content: EMILY E DENK CRNA (NPI 1447690250)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447690250 NPI number — EMILY E DENK CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DENK
Provider First Name:
EMILY
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447690250
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12511 WORLD PLAZA LN
Provider Second Line Business Mailing Address:
BUILDING 50
Provider Business Mailing Address City Name:
FORT MYERS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33907-3991
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-939-2622
Provider Business Mailing Address Fax Number:
239-939-0151

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12511 WORLD PLAZA LN
Provider Second Line Business Practice Location Address:
BUILDING 50
Provider Business Practice Location Address City Name:
FORT MYERS
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33907-3991
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-939-2622
Provider Business Practice Location Address Fax Number:
239-939-0151
Provider Enumeration Date:
06/26/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  ARNP9292126 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)