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General NPI Number Information
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NPI Number | 1629405642
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Entity Type | Individual
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Provider Name | MEGHAN MARIE RADER CRNA
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Gender | Female
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Dates
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Enumeration Date | 10/04/2013
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 350 W THOMAS RD
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City | PHOENIX
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State | AZ
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Zip | 85013-4409
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Country | US
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Telephone | 602-406-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 15421 N 1ST AVE
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City | PHOENIX
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State | AZ
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Zip | 85023-3609
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Country | US
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Telephone | 602-358-9514
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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 | CRNA0978
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License Number State | AZ
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