Organization
LAKE ERIE ANESTHESIA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY J FITZPATRICK CRNA (PRESIDENT)
(440) 998-0000
Entity
Organization
Contact information
Practice address
2893 N RIDGE E, ASHTABULA, OH 44004-4134
(440) 998-0000
Mailing address
2893 N RIDGE E, ASHTABULA, OH 44004-4134
(440) 998-0000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2858288
—
OH
01
—
DG8978
RAILROAD MEDICARE
OH
Enumeration date
12/26/2007
Last updated
12/08/2008
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