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General NPI Number Information
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NPI Number | 1427245109
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Entity Type | Organization
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Legal Business Name | SUSAN G. TAYLOR, CRNA CORP
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Dates
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Enumeration Date | 09/26/2007
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Last Update Date | 05/22/2008
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Provider Practice Location Address
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Address Line | 7525 69TH AVE NE
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City | MARYSVILLE
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State | WA
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Zip | 98270-7788
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Country | US
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Telephone | 360-653-3588
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2329
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City | MOUNT VERNON
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State | WA
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Zip | 98273-7329
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Country | US
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Telephone | 360-336-6517
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUSAN G TAYLOR
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Credential | CRNA
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Telephone | 360-653-3588
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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 | AP30005906
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License Number State | WA
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