MEDICARE: MS. ANN M MCHALE-SASS CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	078040532CRNA	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093710725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANN M MCHALE-SASS CRNA

Provider Business Mailing Address
First Line	:	400 E 10TH ST
Second Line	:
City	:	WACONIA
State	:	MN
Zip	:	55387-4552
Country	:	US
Telephone Number	:	952-442-9770
Fax Number	:	952-442-3620

Provider Business Practice Location Address
First Line	:	65W1 DIVISION AVE.
Second Line	:	PMB 114
City	:	EUGENE
State	:	OR
Zip	:	97404-2485
Country	:	US
Telephone Number	:	541-689-0864
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	09/26/2011

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