Provider Demographics
NPI:1598028599
Name:CROSBY, CHARLIE (CRNA)
Entity Type:Individual
Prefix:MISS
First Name:CHARLIE
Middle Name:
Last Name:CROSBY
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 1:3309 SW 34TH CIR
Mailing Address - Street 2:STE 101
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34474-3392
Mailing Address - Country:US
Mailing Address - Phone:352-237-2400
Mailing Address - Fax:352-304-6327
Practice Address - Street 1:3309 SW 34TH CIR
Practice Address - Street 2:STE 101
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-3392
Practice Address - Country:US
Practice Address - Phone:352-237-2400
Practice Address - Fax:352-304-6327
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9228538367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered