MEDICARE: JEANNE A CHARNEY 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	RN535619	CA
2	367500000X	Certified Registered Nurse Anesthetist	2411	CA

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	:	1669457446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANNE A CHARNEY CRNA

Provider Business Mailing Address
First Line	:	PO BOX 765
Second Line	:
City	:	COLTON
State	:	CA
Zip	:	92324-0765
Country	:	US
Telephone Number	:	909-580-2440
Fax Number	:	909-889-7034

Provider Business Practice Location Address
First Line	:	400 N PEPPER AVE
Second Line	:	ANESTHESIA DEPARTMENT, 2ND FLOOR
City	:	COLTON
State	:	CA
Zip	:	92324-1819
Country	:	US
Telephone Number	:	909-580-2440
Fax Number	:	909-889-7034

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

Provider Enumeration Date	:	12/14/2005
Last Update Date	:	09/25/2013

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Directions to “ JEANNE A CHARNEY CRNA” Practice Location

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