MEDICARE: MRS. EUNAI DANEK 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	4704099094	MI

General Provider Information

NPI Number	:	1215055454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EUNAI DANEK CRNA

Provider Business Mailing Address
First Line	:	34 ELDER DR
Second Line	:
City	:	MARQUETTE
State	:	MI
Zip	:	49855-1631
Country	:	US
Telephone Number	:	906-228-5184
Fax Number	:

Provider Business Practice Location Address
First Line	:	2571 CASCADE CREEK DR
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49203-3771
Country	:	US
Telephone Number	:	517-784-1473
Fax Number	:

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

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	07/08/2007

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