Individual
FORTUNATA MASHIBE
Active
Individual
FORTUNATA MASHIBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28161083A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000847539
ANTHEM PROVIDER NUMBER
IN
05
—
201198840
—
IN
Enumeration date
11/01/2013
Last updated
06/15/2020
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