Individual
JACQUELINE MULDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
501 6TH AVE S, SAINT PETERSBURG, FL 33701-4634
(727) 898-7451
Mailing address
2119 CATALONIA WAY S, SAINT PETERSBURG, FL 33712-4159
(616) 299-5485
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
4704311252
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11019591
FL
367500000X
Certified Registered Nurse Anesthetist
RN9448689
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114607100
—
FL
Enumeration date
02/12/2022
Last updated
03/19/2025
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