Provider Demographics
NPI:1437115938
Name:KAUFMANN, DAVID T (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:T
Last Name:KAUFMANN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:T
Other - Last Name:KAUFMANN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:2572 PEAKE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34286-6006
Mailing Address - Country:US
Mailing Address - Phone:724-255-1928
Mailing Address - Fax:
Practice Address - Street 1:2572 PEAKE ST
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34286-6006
Practice Address - Country:US
Practice Address - Phone:724-255-1928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-24
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN356004L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA071065OtherAANA NO.