MEDICARE: MRS. AMY CELESTE METOYER 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	AP137636	TX

General Provider Information

NPI Number	:	1346739810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY CELESTE METOYER CRNA

Provider Business Mailing Address
First Line	:	6703 WINTON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021-2428
Country	:	US
Telephone Number	:	337-661-9497
Fax Number	:

Provider Business Practice Location Address
First Line	:	6703 WINTON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77021-2428
Country	:	US
Telephone Number	:	337-661-9497
Fax Number	:

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

Provider Enumeration Date	:	05/09/2018
Last Update Date	:	03/29/2019

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