Healthcare Provider Details

I. General information

NPI: 1841399524
Provider Name (Legal Business Name): BARBARA L BUCCI CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BARBARA L ROLAND RN

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1086 FRANKLIN ST
JOHNSTOWN PA
15905
US

IV. Provider business mailing address

455 HELSEL ROAD
JOHNSTOWN PA
15904
US

V. Phone/Fax

Practice location:
  • Phone: 814-534-9321
  • Fax:
Mailing address:
  • Phone: 814-266-6566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number035076
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: