Provider Demographics
NPI:1598801979
Name:CRERAR, CHRISTOPHER R (CRNA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:R
Last Name:CRERAR
Suffix:
Gender:M
Credentials:CRNA
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Other - First Name:
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Mailing Address - Street 1:PO BOX 1538
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32004-1538
Mailing Address - Country:US
Mailing Address - Phone:904-449-7246
Mailing Address - Fax:904-719-7571
Practice Address - Street 1:4796 HODGES BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224
Practice Address - Country:US
Practice Address - Phone:904-449-7246
Practice Address - Fax:904-719-7571
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2019-07-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024167242367500000X
FLARNP9493691367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered