Provider Demographics
NPI:1376853259
Name:KROUT, JENNIFER (CRNA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:KROUT
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8422 E SHEA BLVD
Mailing Address - Street 2:103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6661
Mailing Address - Country:US
Mailing Address - Phone:480-478-6620
Mailing Address - Fax:480-478-6628
Practice Address - Street 1:8422 E SHEA BLVD
Practice Address - Street 2:103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6661
Practice Address - Country:US
Practice Address - Phone:480-478-6620
Practice Address - Fax:480-478-6628
Is Sole Proprietor?:No
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZRN146412163W00000X
OHIR949482163W00000X
CARN593562163W00000X
AZCRNA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse