Individual
MRS. MARY KATHRYN NENTWIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3687
(352) 273-8610
(352) 273-8612
Mailing address
PO BOX 100254, GAINESVILLE, FL 32610-0254
(352) 273-8610
(352) 273-8612
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN9496801
FL
367500000X
Certified Registered Nurse Anesthetist
RN247765L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101904300
—
FL
Enumeration date
11/01/2006
Last updated
02/06/2020
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