Provider Demographics
NPI:1720399033
Name:DEANGELIS, KAREN KLEINFELDT (CRNA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:KLEINFELDT
Last Name:DEANGELIS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:K
Other - Last Name:TATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:1514 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2429
Practice Address - Country:US
Practice Address - Phone:504-842-3755
Practice Address - Fax:504-842-2036
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9306054367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2157850Medicaid
MS00977287Medicaid
LA3C6657061Medicare PIN
MS00977287Medicaid