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NPI Code Detail

MEDICARE: KATHARINE SAN MACAULAY CRNA

MEDICARE: KATHARINE SAN MACAULAY CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology Physician95070CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215932868
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHARINE SAN MACAULAY CRNA
Provider Business Mailing Address
First Line : PO BOX 911244
Second Line :
City : PUEBLO
State : CO
Zip : 81004
Country : US
Telephone Number : 719-557-4221
Fax Number : 719-557-3834
Provider Business Practice Location Address
First Line : 1008 MINNEQUA AVE
Second Line :
City : PUEBLO
State : CO
Zip : 81004-3733
Country : US
Telephone Number : 719-557-4221
Fax Number : 719-557-3834
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 08/29/2013

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Directions to “ KATHARINE SAN MACAULAY CRNA” Practice Location

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