Provider Demographics
NPI:1467019208
Name:CURTIS, ROBERT TREVOR (CRNA)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:TREVOR
Last Name:CURTIS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 AVENTINE DR APT 205
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-0350
Mailing Address - Country:US
Mailing Address - Phone:317-908-9177
Mailing Address - Fax:
Practice Address - Street 1:9100 DR. MLK JR. ST. N
Practice Address - Street 2:APARTMENT 1206
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702
Practice Address - Country:US
Practice Address - Phone:317-908-9177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-28
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC367500000X367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered