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General NPI Number Information
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NPI Number | 1306840095
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Entity Type | Individual
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Provider Name | MAUREEN BYRNE CRNA
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Gender | Female
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2601 HOLME AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19152-2007
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Country | US
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Telephone | 215-335-6618
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Fax |
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Provider Business Mailing Address
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Address Line | 10956 ELLICOTT RD
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City | PHILADELPHIA
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State | PA
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Zip | 19154-4410
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Country | US
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Telephone | 215-501-0994
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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 | RN295375L
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License Number State | PA
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