Provider Demographics
NPI:1497930069
Name:ESLAVA, MISTY DOWNEY (CRNA)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:DOWNEY
Last Name:ESLAVA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MISTY
Other - Middle Name:
Other - Last Name:DOWNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 757
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35631-0757
Mailing Address - Country:US
Mailing Address - Phone:256-764-9697
Mailing Address - Fax:256-764-9699
Practice Address - Street 1:2890 DAUPHIN ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36606-2457
Practice Address - Country:US
Practice Address - Phone:251-473-2020
Practice Address - Fax:251-479-6737
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-092794367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered