Provider Demographics
NPI:1346548757
Name:DERAY, CHRISTOPHER TOWNSEND (CRNA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:TOWNSEND
Last Name:DERAY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:DERAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CRNA
Mailing Address - Street 1:8134 POE CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-2449
Mailing Address - Country:US
Mailing Address - Phone:904-374-3420
Mailing Address - Fax:904-374-3420
Practice Address - Street 1:8134 POE CT
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-2449
Practice Address - Country:US
Practice Address - Phone:904-374-3420
Practice Address - Fax:904-374-3420
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2849082367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered