Provider Demographics
NPI:1609968866
Name:TOKARZ, NANCY Y (CRNA)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:Y
Last Name:TOKARZ
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 1:1200 37TH ST
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-6509
Mailing Address - Country:US
Mailing Address - Phone:772-770-5600
Mailing Address - Fax:772-770-1763
Practice Address - Street 1:1200 37TH ST
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6509
Practice Address - Country:US
Practice Address - Phone:772-770-5600
Practice Address - Fax:772-770-1763
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704157518367500000X
FL9295944367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4408840Medicaid
MI4408840Medicaid
MI0N21370138Medicare ID - Type Unspecified