Healthcare Provider Details
I. General information
NPI: 1801185517
Provider Name (Legal Business Name): PATRICIA M RATH CRNA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/04/2011
Last Update Date: 04/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1818 E 23RD AVE
HUTCHINSON KS
67502-1106
US
IV. Provider business mailing address
PO BOX 388
NEWTON KS
67114-0388
US
V. Phone/Fax
- Phone: 620-663-4800
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PATRICIA
RATH
Title or Position: OWNER
Credential: CRNA
Phone: 316-281-3700