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EUTORIA LEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
111 S 11TH ST STE G8490, PHILADELPHIA, PA 19107-4824
(215) 955-1120
(215) 923-5507
Mailing address
111 S 11TH ST STE G8490, PHILADELPHIA, PA 19107-4824
(215) 955-6161
(215) 923-5507

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
L6-0A00617
DE
367500000X
Certified Registered Nurse Anesthetist
Primary
RN300599L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
085035
AANA #
01
26NR13529500
RN LICENSE
NJ
01
L1-0039640
RN LICENSE
DE
01
RN300599L
RN LICENSE
PA
Enumeration date
12/13/2010
Last updated
08/06/2019
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