Healthcare Provider Details

I. General information

NPI: 1699724773
Provider Name (Legal Business Name): MARGARET FUECHTMAN CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 01/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 MACARTHUR BLVD
MUNSTER IN
46321-3901
US

IV. Provider business mailing address

901 MACARTHUR BOULEVARD ANESTHESIA DEPARTMENT
MUNSTER IN
46321-2901
US

V. Phone/Fax

Practice location:
  • Phone: 219-836-1600
  • Fax: 219-513-1127
Mailing address:
  • Phone: 219-836-7040
  • Fax: 219-513-1127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number2815166A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number28151669A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: