MEDICARE: COURTNEY MCGUIGAN 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	086835	CT

General Provider Information

NPI Number	:	1336445329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY MCGUIGAN CRNA

Provider Business Mailing Address
First Line	:	41 EDINBURGH LN
Second Line	:
City	:	MADISON
State	:	CT
Zip	:	06443-3411
Country	:	US
Telephone Number	:	516-521-8054
Fax Number	:

Provider Business Practice Location Address
First Line	:	41 EDINBURGH LN
Second Line	:
City	:	MADISON
State	:	CT
Zip	:	06443-3411
Country	:	US
Telephone Number	:	516-521-8054
Fax Number	:

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

Provider Enumeration Date	:	02/08/2011
Last Update Date	:	02/08/2011

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