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NPI Code Detail

MEDICARE: MR. JASON BOYD GIROUARD CRNA, MSN

MEDICARE: MR. JASON BOYD GIROUARD CRNA, MSN
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 AnesthetistCRNA000292NV
2367500000XCertified Registered Nurse AnesthetistAP131818TX

General Provider Information

NPI Number : 1285636191
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JASON BOYD GIROUARD CRNA, MSN
Provider Business Mailing Address
First Line : PO BOX 160
Second Line :
City : SHIPROCK
State : NM
Zip : 87420-0160
Country : US
Telephone Number : 505-368-6001
Fax Number :
Provider Business Practice Location Address
First Line : US HWY 491 NORTH
Second Line :
City : SHIPROCK
State : NM
Zip : 87420
Country : US
Telephone Number : 505-368-6001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 12/19/2019

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