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NPI Code Detail

MEDICARE: JAMES CHUSTZ CRNA

MEDICARE: JAMES CHUSTZ 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
1367500000XCertified Registered Nurse AnesthetistRN037219LA

General Provider Information

NPI Number : 1275560468
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES CHUSTZ CRNA
Provider Business Mailing Address
First Line : 6300 MAIN ST
Second Line :
City : ZACHARY
State : LA
Zip : 70791-4037
Country : US
Telephone Number : 225-658-4000
Fax Number : 225-658-4274
Provider Business Practice Location Address
First Line : 6300 MAIN ST
Second Line :
City : ZACHARY
State : LA
Zip : 70791-4037
Country : US
Telephone Number : 225-658-4000
Fax Number : 225-658-4274
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2006
Last Update Date : 05/27/2008

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