Provider Demographics
NPI:1659710697
Name:KROBERT, DAVID BENJAMIN (CRNA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BENJAMIN
Last Name:KROBERT
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 BROCKENBRAUGH ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-3715
Mailing Address - Country:US
Mailing Address - Phone:773-791-9197
Mailing Address - Fax:
Practice Address - Street 1:1520 BROCKENBRAUGH ST
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-3715
Practice Address - Country:US
Practice Address - Phone:773-791-9197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-24
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7301367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03622083Medicaid
LA2341049Medicaid
LA2341049Medicaid