Individual
SINTAHYU MULATA
Active
Individual
SINTAHYU MULATA
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
28074199A
IN
367500000X
Certified Registered Nurse Anesthetist
430060834
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000189991
BCBS OF INDIANA
IN
05
—
20043140A
—
IN
01
—
209003179
BCBSIL
IL
Enumeration date
11/30/2006
Last updated
01/04/2011
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