Individual
MS. KATRINA SUE VANTASSEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1304 OAK ST, MELBOURNE, FL 32901-3111
(321) 723-4723
(321) 727-1448
Mailing address
1304 OAK STREET, MELBOURNE, FL 32901-3111
(321) 723-4723
(321) 727-1448
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9245162
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308248200
—
FL
01
—
G4232
BCBSFL
FL
01
—
P00424084
RMCR
FL
Enumeration date
02/21/2007
Last updated
06/11/2008
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