Healthcare Provider Details

I. General information

NPI: 1609824291
Provider Name (Legal Business Name): JON FRANCIS GARRIGAN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 04/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7710 MERCY RD STE 424
OMAHA NE
68124-2346
US

IV. Provider business mailing address

7710 MERCY RD STE 424
OMAHA NE
68124-2346
US

V. Phone/Fax

Practice location:
  • Phone: 402-398-6176
  • Fax: 402-398-5576
Mailing address:
  • Phone: 402-398-6176
  • Fax: 402-398-5576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number100607
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: