Provider Demographics
NPI:1528017274
Name:STAFFORD, REBECCA JANE (CRNA)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:JANE
Last Name:STAFFORD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
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Mailing Address - Street 1:5208 QUARRYSTONE LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-2506
Mailing Address - Country:US
Mailing Address - Phone:813-598-2345
Mailing Address - Fax:813-962-1332
Practice Address - Street 1:5208 QUARRYSTONE LN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-2506
Practice Address - Country:US
Practice Address - Phone:813-598-2345
Practice Address - Fax:813-962-1332
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2011-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLARNP-1503412367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered