Healthcare Provider Details

I. General information

NPI: 1992802052
Provider Name (Legal Business Name): WILLIAM L TROUSKIE JR. CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 AIRPORT RD
RIFLE CO
81650-8510
US

IV. Provider business mailing address

694 N CEDAR SPRINGS RANCH RD
RIFLE CO
81650-8559
US

V. Phone/Fax

Practice location:
  • Phone: 970-625-1510
  • Fax:
Mailing address:
  • Phone: 970-440-7045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number0015066
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: