MEDICARE: MS. DEBORAH S ROUCHON 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	ARNP2524962	FL
2	367500000X	Certified Registered Nurse Anesthetist	1099209	AL
3	367500000X	Certified Registered Nurse Anesthetist	RN162867	GA
4	367500000X	Certified Registered Nurse Anesthetist	3852A	KY
5	367500000X	Certified Registered Nurse Anesthetist	190868	NC
6	367500000X	Certified Registered Nurse Anesthetist	NA07233	OH
7	367500000X	Certified Registered Nurse Anesthetist	RN542278	PA
8	367500000X	Certified Registered Nurse Anesthetist	APN881	SC
9	367500000X	Certified Registered Nurse Anesthetist	RN138713	TN
10	367500000X	Certified Registered Nurse Anesthetist	24165930	VA

Other Identifiers

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

General Provider Information

NPI Number	:	1538162540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBORAH S ROUCHON CRNA

Provider Business Mailing Address
First Line	:	1009 OAK CIR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-6627
Country	:	US
Telephone Number	:	727-686-2063
Fax Number	:	727-781-7090

Provider Business Practice Location Address
First Line	:	1009 OAK CIR
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34683-6627
Country	:	US
Telephone Number	:	727-686-2063
Fax Number	:	727-781-7090

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	07/08/2007

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