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NPI Code Detail

MEDICARE: MRS. SUSAN RAKOVAN CRNA

MEDICARE: MRS. SUSAN RAKOVAN 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
1367500000XCertified Registered Nurse AnesthetistRN278569LPA

General Provider Information

NPI Number : 1407825334
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN RAKOVAN CRNA
Provider Business Mailing Address
First Line : 122 CHRISTLER CT
Second Line :
City : MOON TOWNSHIP
State : PA
Zip : 15108-1359
Country : US
Telephone Number : 412-299-7776
Fax Number :
Provider Business Practice Location Address
First Line : 25 HECKEL RD
Second Line :
City : MC KEES ROCKS
State : PA
Zip : 15136-1651
Country : US
Telephone Number : 412-777-6161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. SUSAN RAKOVAN CRNA” Practice Location

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