MEDICARE: SURGICAL NURSING CONSULTANTS, INC

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	363LF0000X	Family Nurse Practitioner	15487	CA
2	163WR0006X	Registered Nurse First Assistant	619814	CA

General Provider Information

NPI Number	:	1568724649
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGICAL NURSING CONSULTANTS, INC

Provider Business Mailing Address
First Line	:	5906 LAGUNA VALE WAY
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95758-4860
Country	:	US
Telephone Number	:	916-687-1016
Fax Number	:	888-329-6432

Provider Business Practice Location Address
First Line	:	5906 LAGUNA VALE WAY
Second Line	:
City	:	ELK GROVE
State	:	CA
Zip	:	95758-4860
Country	:	US
Telephone Number	:	916-687-1016
Fax Number	:	888-329-6432

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEPHANIE L BIANCHI
Credential	:	NP-C, RNFA
Telephone Number	:	916-687-1016

Provider Enumeration Date	:	06/13/2012
Last Update Date	:	05/31/2013

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