Provider Demographics
NPI:1063458644
Name:PALMERI, CHRISTINA (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:
Last Name:PALMERI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4087 SE OLD SAINT LUCIE BLVD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-5161
Mailing Address - Country:US
Mailing Address - Phone:772-223-6676
Mailing Address - Fax:
Practice Address - Street 1:4087 SE OLD SAINT LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-5161
Practice Address - Country:US
Practice Address - Phone:772-223-6676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-21
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9256282367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308484100Medicaid
FLG4336OtherBCBS
CAZ441893OtherNUID (KAISER SO CA)
CAZ441893OtherNUID (KAISER SO CA)