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NPI Code Detail

MEDICARE: CHARLES DEAN CRNA

MEDICARE: CHARLES DEAN 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 AnesthetistRN181488LPA

General Provider Information

NPI Number : 1477554087
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES DEAN CRNA
Provider Business Mailing Address
First Line : PO BOX 1032
Second Line :
City : UNIONTOWN
State : PA
Zip : 15401-1032
Country : US
Telephone Number : 201-804-2800
Fax Number :
Provider Business Practice Location Address
First Line : 500 W BERKELEY ST
Second Line :
City : UNIONTOWN
State : PA
Zip : 15401-5514
Country : US
Telephone Number : 724-437-6730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2005
Last Update Date : 07/08/2007

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Directions to “ CHARLES DEAN CRNA” Practice Location

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