MEDICARE: MS. CYNTHIA F DILLARD 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	1-030630	AL

General Provider Information

NPI Number	:	1417943473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA F DILLARD CRNA

Provider Business Mailing Address
First Line	:	PO BOX 55905
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35255-5905
Country	:	US
Telephone Number	:	205-979-5882
Fax Number	:	205-979-1248

Provider Business Practice Location Address
First Line	:	1201 11TH AVE S
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-3423
Country	:	US
Telephone Number	:	205-930-7296
Fax Number	:	205-930-7256

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

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	07/08/2007

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