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NPI Code Detail

MEDICARE: JULIE A MCBROOM CRNA

MEDICARE: JULIE A MCBROOM 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 Anesthetist14317TN

General Provider Information

NPI Number : 1821094608
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE A MCBROOM CRNA
Provider Business Mailing Address
First Line : PO BOX 3572
Second Line :
City : JACKSON
State : TN
Zip : 38303-3572
Country : US
Telephone Number : 731-668-1853
Fax Number : 731-664-7731
Provider Business Practice Location Address
First Line : 620 SKYLINE DR
Second Line :
City : JACKSON
State : TN
Zip : 38301-3923
Country : US
Telephone Number : 731-668-1853
Fax Number : 731-664-7731
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/25/2005
Last Update Date : 03/29/2011

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Directions to “ JULIE A MCBROOM CRNA” Practice Location

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