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General NPI Number Information
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NPI Number | 1275504789
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Entity Type | Organization
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Legal Business Name | MICHELLE EISENBERGER
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | USA MEDDAC , EVANS ARMY COMMUNITY HOSPITAL 1650 COCHRANE CIRCLE
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City | FORT CARSON
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State | CA
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Zip | 80913-4604
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Country | US
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Telephone | 719-526-7844
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Fax | 719-526-7984
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Provider Business Mailing Address
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Address Line | USA MEDDAC , EVANS ARMY COMMUNITY HOSPITAL 1650 COCHRANE CIRCLE
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City | FORT CARSON
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State | CA
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Zip | 80913-4604
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Country | US
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Telephone | 719-526-7844
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Fax | 719-526-7984
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Authorized Official
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Title or Position | NURSE ANESTHETIST
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Name | MRS. MICHELLE EISENBERGER
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Credential | CRNA
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Telephone | 719-527-1213
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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 | 99227
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License Number State | TN
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