Ellen Marie Roth C.R.N.A.

NPI 1093885253 - Nurse Anesthetist, Certified Registered - 367500000X

NPI Details
NPI 1093885253
Gender Female
Enumeration Date 11/08/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
9961 SIERRA AVE
ANESTHESIA DEPARTMENT
FONTANA CA, 92335-6720, US
Phone (909) 427-7162
Fax
Business Location
475 E CYPRESS AVE
APT. #302
REDLANDS CA, 92373-6169, US
Phone (909) 792-1918
Fax
Toxanomy
Taxonomy Code 367500000X
License State California
License Number 436360
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According to our database, Ellen Marie Roth C.R.N.A. NPI is 1093885253, taxonomy code is 367500000X and license number is 436360, license state is located at California. Ellen Marie Roth C.R.N.A. physically located at 9961 Sierra Ave, Fontana CA, 92335-6720. NPI Number Ellen Marie Roth C.R.N.A. has the Individual type.

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1093885253 NPI number is provided on an as is basis without warranty of any kind. 1093885253 is maintained by the National Plan & Provider Enumeration System. The contents of Ellen Marie Roth C.R.N.A. are for informational purposes only.