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General NPI Number Information
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NPI Number | 1609686351
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Entity Type | Organization
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Legal Business Name | BOUGIE CRNA LLC
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 13760 N 93RD AVE STE 101
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City | PEORIA
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State | AZ
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Zip | 85381-4203
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Country | US
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Telephone | 623-547-2600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 41150
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City | MESA
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State | AZ
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Zip | 85274-1150
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Country | US
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Telephone | 480-425-2160
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Fax | 480-839-4727
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Authorized Official
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Title or Position | OWNER
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Name | GWLADYS DOROTHEE EMAZE BEST
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Credential | CRNA
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Telephone | 202-557-6453
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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 |
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License Number State |
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