Healthcare Provider Details

I. General information

NPI: 1992703755
Provider Name (Legal Business Name): BARBARA MURTAGH CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 02/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10951 GULF SHORE DR 301
NAPLES FL
34108-1744
US

IV. Provider business mailing address

10951 GULF SHORE DR 301
NAPLES FL
34108-1744
US

V. Phone/Fax

Practice location:
  • Phone: 419-509-2088
  • Fax:
Mailing address:
  • Phone: 419-509-2088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number133277
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: