Provider Demographics
NPI:1376874271
Name:DUMAS, ELIZABETH R (CRNA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:R
Last Name:DUMAS
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 3756
Mailing Address - Street 2:
Mailing Address - City:KINGSHILL
Mailing Address - State:VI
Mailing Address - Zip Code:00851-3756
Mailing Address - Country:US
Mailing Address - Phone:251-232-7349
Mailing Address - Fax:
Practice Address - Street 1:3004 ORANGE GROVE
Practice Address - Street 2:
Practice Address - City:CHRISTIANSTED
Practice Address - State:ST CROIX
Practice Address - Zip Code:00820
Practice Address - Country:UM
Practice Address - Phone:251-232-7349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-18
Last Update Date:2015-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9262288367500000X
VIAP12538367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered