Provider Demographics
NPI:1710094982
Name:DAY, CARMELITA M (CRNA)
Entity Type:Individual
Prefix:MS
First Name:CARMELITA
Middle Name:M
Last Name:DAY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:CARMEN
Other - Middle Name:M
Other - Last Name:DAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:11345 BROOKLYN RD
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36421-6407
Mailing Address - Country:US
Mailing Address - Phone:334-427-1021
Mailing Address - Fax:334-427-3021
Practice Address - Street 1:11345 BROOKLYN RD
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36421-6407
Practice Address - Country:US
Practice Address - Phone:334-427-1021
Practice Address - Fax:334-427-3021
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2009-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL123467367500000X
FLARNP9245967367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered