Provider Demographics
NPI:1295010601
Name:DE ARAUJO JORGE, KATHERINE CHRISTINE (CRNA)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:CHRISTINE
Last Name:DE ARAUJO JORGE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5801 CROSSINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-3130
Mailing Address - Country:US
Mailing Address - Phone:615-941-8501
Mailing Address - Fax:615-941-8102
Practice Address - Street 1:5801 CROSSINGS BLVD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-3130
Practice Address - Country:US
Practice Address - Phone:615-941-8501
Practice Address - Fax:615-941-8102
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN15517367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered