Provider Demographics
NPI:1558331694
Name:NAUMANN, GENA MARIE (CRNA)
Entity type:Individual
Prefix:MS
First Name:GENA
Middle Name:MARIE
Last Name:NAUMANN
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 1:191 SAN REMO DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-8731
Mailing Address - Country:US
Mailing Address - Phone:561-622-2569
Mailing Address - Fax:
Practice Address - Street 1:191 SAN REMO DR
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-8731
Practice Address - Country:US
Practice Address - Phone:561-622-2569
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1883782367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG1919OtherBLUE CROSS BLUE SHIELD
FL304986800Medicaid
FLG1919OtherBLUE CROSS BLUE SHIELD