Provider Demographics
NPI:1275568248
Name:RAILE, CHRISTY ANN (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:ANN
Last Name:RAILE
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:PO BOX 862810
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-2810
Mailing Address - Country:US
Mailing Address - Phone:813-994-2747
Mailing Address - Fax:302-709-2402
Practice Address - Street 1:8930 MAGNOLIA CHASE CIR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2219
Practice Address - Country:US
Practice Address - Phone:813-994-2747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9231577367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307324600Medicaid
FLG3831OtherFL BCBS PROVIDER #
FL307324600Medicaid