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NPI Code Detail

MEDICARE: MARY ROHMAN CRNA

MEDICARE: MARY ROHMAN 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 AnesthetistR555398MS

General Provider Information

NPI Number : 1780711820
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ROHMAN CRNA
Provider Business Mailing Address
First Line : PO BOX 174
Second Line :
City : YAZOO CITY
State : MS
Zip : 39194-0174
Country : US
Telephone Number : 662-746-2261
Fax Number : 662-751-8226
Provider Business Practice Location Address
First Line : 823 GRAND AVE
Second Line :
City : YAZOO CITY
State : MS
Zip : 39194-3233
Country : US
Telephone Number : 662-751-8156
Fax Number : 662-751-8226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 07/08/2007

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