MEDICARE: PAUL SVINGEN 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
1	367500000X	Certified Registered Nurse Anesthetist	95910	WI

General Provider Information

NPI Number	:	1417923921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL SVINGEN CRNA

Provider Business Mailing Address
First Line	:	112 SANDY CT
Second Line	:
City	:	MOUNT HOREB
State	:	WI
Zip	:	53572-2344
Country	:	US
Telephone Number	:	608-437-4662
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 SANDY CT
Second Line	:
City	:	MOUNT HOREB
State	:	WI
Zip	:	53572-2344
Country	:	US
Telephone Number	:	608-437-4662
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	12/21/2016

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