Provider Demographics
NPI:1285972158
Name:CHIRLIN, ELIZABETH JOANNE (CRNA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JOANNE
Last Name:CHIRLIN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:ANESTHESIA DEPT
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45005
Mailing Address - Country:US
Mailing Address - Phone:513-424-2111
Mailing Address - Fax:
Practice Address - Street 1:9507 BENCHMARK LN
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-6005
Practice Address - Country:US
Practice Address - Phone:513-477-7391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-28
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH344094163W00000X
CA766634163W00000X
NY668133163W00000X
OH19086367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse