Provider Demographics
NPI:1447672159
Name:KONRAD, JAIME RENEE (CRNA)
Entity type:Individual
Prefix:MS
First Name:JAIME
Middle Name:RENEE
Last Name:KONRAD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:195 HICKS ST
Mailing Address - Street 2:APT 5C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-4185
Mailing Address - Country:US
Mailing Address - Phone:314-276-7381
Mailing Address - Fax:
Practice Address - Street 1:70 REMSEN ST
Practice Address - Street 2:APT 9A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3432
Practice Address - Country:US
Practice Address - Phone:314-276-7381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY570180-1163W00000X
NJ26NR15322600367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse