Provider Demographics
NPI:1366114324
Name:CUZZILLA, STEVEN (RN, BSN, CRNA-DNAP)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:CUZZILLA
Suffix:
Gender:M
Credentials:RN, BSN, CRNA-DNAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1894 E WILLIAM ST STE 4
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-3202
Mailing Address - Country:US
Mailing Address - Phone:901-647-0871
Mailing Address - Fax:
Practice Address - Street 1:1894 E WILLIAM ST STE 4
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-3202
Practice Address - Country:US
Practice Address - Phone:901-647-0871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV882445163W00000X, 367500000X
TN37931367500000X
TN203568163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
00000OtherN/A