Individual provider · Type 1 NPI

Glen Deitrick, C.R.N.A

Certified Registered Nurse Anesthetist · Gulfport, MS

NPI number 1033214564 Active

Practice location

15190 Community Rd, Suite 230A
Gulfport, MS 39503-3485

Call (228) 831-0204 Map

Fax (228) 831-1868

Specialties and licenses

TaxonomyCodeLicense
Certified Registered Nurse Anesthetist Primary 367500000XR128610 (MS)

Certified Registered Nurse Anesthetist: (1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of creden…

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About NPI 1033214564

Glen Deitrick, C.R.N.A's National Provider Identifier is 1033214564, issued on Sep 13, 2006. The primary taxonomy on file is Certified Registered Nurse Anesthetist (367500000X), and the practice location is in Gulfport, MS. The record was last updated on Jul 8, 2007.