Provider Demographics
NPI:1386880847
Name:BURCIU, AMELIA MONICA (CRNA)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:MONICA
Last Name:BURCIU
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:AMELIA
Other - Middle Name:MONICA
Other - Last Name:TOFANEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:972-233-1999
Mailing Address - Fax:972-233-3666
Practice Address - Street 1:4916 OVERTON PLZ
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109
Practice Address - Country:US
Practice Address - Phone:888-804-3000
Practice Address - Fax:817-877-0899
Is Sole Proprietor?:No
Enumeration Date:2009-01-05
Last Update Date:2018-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX679908367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGOtherBLUE CROSS BLUE SHIELD
TXPENDINGMedicaid
TXPENDINGOtherBLUE CROSS BLUE SHIELD