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General NPI Number Information
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NPI Number | 1144680216
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Entity Type | Individual
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Provider Name | SCOTT THOMAS JOYCE CRNA
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Gender | Male
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Dates
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Enumeration Date | 03/02/2016
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 1221 S GEAR AVE
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City | WEST BURLINGTON
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State | IA
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Zip | 52655-1679
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Country | US
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Telephone | 319-768-1000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 840853
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City | DALLAS
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State | TX
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Zip | 75284-0853
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Country | US
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Telephone | 713-922-8122
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 791883
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP130150
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | D151008
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License Number State | IA
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