Healthcare Provider Details

I. General information

NPI: 1639535917
Provider Name (Legal Business Name): CLAYTON R EYLER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2016
Last Update Date: 10/21/2020
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 CARLISLE ST
NATRONA HEIGHTS PA
15065-1152
US

IV. Provider business mailing address

1301 CARLISLE ST
NATRONA HEIGHTS PA
15065-1152
US

V. Phone/Fax

Practice location:
  • Phone: 724-226-7010
  • Fax: 724-226-7404
Mailing address:
  • Phone: 724-226-7010
  • Fax: 724-226-7404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN572577
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: