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General NPI Number Information
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NPI Number | 1427360809
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Entity Type | Individual
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Provider Name | LAURIE MCATEE CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/13/2010
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Last Update Date | 07/16/2014
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Provider Practice Location Address
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Address Line | 7309 N KNOXVILLE AVE
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City | PEORIA
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State | IL
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Zip | 61614-2085
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Country | US
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Telephone | 309-692-9210
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Fax |
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Provider Business Mailing Address
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Address Line | 1271 E MONROE ST
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City | MORTON
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State | IL
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Zip | 61550-2428
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Country | US
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Telephone | 309-258-3335
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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 | 209008224
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License Number State | IL
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