MEDICARE: JAMES D HARRELL 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	1-087270	AL

General Provider Information

NPI Number	:	1316913148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES D HARRELL CRNA

Provider Business Mailing Address
First Line	:	3714 OLD BRANCH CIR
Second Line	:
City	:	JASPER
State	:	AL
Zip	:	35504-9155
Country	:	US
Telephone Number	:	205-221-1264
Fax Number	:	205-221-1264

Provider Business Practice Location Address
First Line	:	3400 HIGHWAY 78 E
Second Line	:
City	:	JASPER
State	:	AL
Zip	:	35501-8956
Country	:	US
Telephone Number	:	205-387-4000
Fax Number	:

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

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	07/08/2007

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Directions to “ JAMES D HARRELL CRNA” Practice Location

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