=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144490830
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARGARET BALL CRNA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/10/2008
-----------------------------------------------------
Last Update Date | 03/10/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2000 EAST LAMAR BLVD. SUITE 400
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76006
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-861-3994
-----------------------------------------------------
Fax | 817-861-3926
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2000 EAST LAMAR BLVD. SUITE 400
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76006
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-861-3994
-----------------------------------------------------
Fax | 817-861-3926
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number | 428182
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------