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General NPI Number Information
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NPI Number | 1275681207
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Entity Type | Organization
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Legal Business Name | UPMC BEDFORD CRNA
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 10455 LINCOLN HWY
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City | EVERETT
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State | PA
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Zip | 15537-7046
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Country | US
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Telephone | 814-623-6161
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Fax | 814-623-3535
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Provider Business Mailing Address
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Address Line | 10455 LINCOLN HWY
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City | EVERETT
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State | PA
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Zip | 15537-7046
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Country | US
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Telephone | 814-623-6161
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Fax | 814-623-3535
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Authorized Official
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Title or Position | CEO
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Name | MR. ROGER WINN
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Credential |
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Telephone | 814-623-1104
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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 | 650501
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License Number State | PA
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