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General NPI Number Information
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NPI Number | 1336693779
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Entity Type | Individual
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Provider Name | BOONE THOMAS CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/14/2016
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 1001 S GEORGE ST
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City | YORK
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State | PA
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Zip | 17403-3676
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Country | US
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Telephone | 717-812-7687
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Fax |
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Provider Business Mailing Address
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Address Line | 601 MEMORY LN
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City | YORK
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State | PA
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Zip | 17402-2231
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Country | US
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Telephone | 717-851-1405
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 7204275-3102
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 94115
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 416967
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 905685
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R246319
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License Number State | MD
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Taxonomy #6
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN658978
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License Number State | PA
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