Basic Information
Provider Information
NPI: 1881812832
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALCEE
FirstName: STEPHANIE
MiddleName: MURIELLE
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 804 SCOTT NIXON MEMORIAL DR
Address2:  
City: AUGUSTA
State: GA
PostalCode: 309072464
CountryCode: US
TelephoneNumber: 8003944445
FaxNumber: 7064348876
Practice Location
Address1: 2727 W. MARTIN LUTHER KING BLVD
Address2: STE #310
City: TAMPA
State: FL
PostalCode: 33607
CountryCode: US
TelephoneNumber: 8133507244
FaxNumber: 8133507246
Other Information
ProviderEnumerationDate: 04/23/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN9215541FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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