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NPI Code Detail

MEDICARE: PROF. NORMALYNN GARRETT CRNA, PHD

MEDICARE:  PROF. NORMALYNN  GARRETT  CRNA, PHD
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 Anesthetist1-037584AL

General Provider Information

NPI Number : 1669462545
Entity Type Code : Individual
Provider Name (Legal Business Name) : PROF. NORMALYNN GARRETT CRNA, PHD
Provider Business Mailing Address
First Line : 14702 WAR ADMIRAL
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78248-1104
Country : US
Telephone Number : 210-286-7984
Fax Number :
Provider Business Practice Location Address
First Line : 5005 N PIEDRAS ST
Second Line : WBAMC, MS DEBRA RODOCKER, CREDENTIALS COORDINATOR
City : EL PASO
State : TX
Zip : 79920-5001
Country : US
Telephone Number : 915-569-1382
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 07/08/2007

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