Provider Demographics
NPI:1548962780
Name:CONEVA, EMILIJA (CRNA)
Entity type:Individual
Prefix:MISS
First Name:EMILIJA
Middle Name:
Last Name:CONEVA
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:PO BOX 13431
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00908-3431
Mailing Address - Country:US
Mailing Address - Phone:562-336-7983
Mailing Address - Fax:
Practice Address - Street 1:604 CALLE CERRA APT 4A
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-3619
Practice Address - Country:US
Practice Address - Phone:562-336-7983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR086827367500000X
CARN95182842367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered