Healthcare Provider Details

I. General information

NPI: 1437862307
Provider Name (Legal Business Name): ERICA M MCGUIRE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2023
Last Update Date: 01/20/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 PINE ST
ABILENE TX
79601-2432
US

IV. Provider business mailing address

301 CYPRESS ST STE 500
ABILENE TX
79601-5842
US

V. Phone/Fax

Practice location:
  • Phone: 325-670-2000
  • Fax:
Mailing address:
  • Phone: 325-670-4250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1108170
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: