Individual
MS. EMILEE REBECCA NIEKRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1600 LAKELAND HILLS BLVD, LAKELAND, FL 33805-3019
(863) 680-7000
(866) 264-8519
Mailing address
PO BOX 95004, LAKELAND, FL 33804-5004
(863) 680-7000
(863) 680-7420
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
ANT9193506
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9193506
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308262800
—
FL
01
—
G4238
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/02/2007
Last updated
06/26/2012
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