Healthcare Provider Details

I. General information

NPI: 1679708804
Provider Name (Legal Business Name): PRISCILLA M PRICE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PRISCILLA M HAMBY

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 11/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7145 PERKINS ROAD
BATON ROUGE LA
70808-4322
US

IV. Provider business mailing address

2920 N CASCADE AVE FL 3
COLORADO SPRINGS CO
80907-6262
US

V. Phone/Fax

Practice location:
  • Phone: 225-765-3111
  • Fax: 225-765-3114
Mailing address:
  • Phone: 636-549-2380
  • Fax: 314-569-5974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR78015
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN103251
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: