MEDICARE: MRS. LOLA HUSSEY 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	544438	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	81568U	OTHER	TX	BCBS
3	430064990	OTHER	TX	RAILROAD

General Provider Information

NPI Number	:	1376503680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LOLA HUSSEY CRNA

Provider Business Mailing Address
First Line	:	7601 HARBOR TOWN DR
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75070-2758
Country	:	US
Telephone Number	:	972-979-0863
Fax Number	:

Provider Business Practice Location Address
First Line	:	6200 W PARKER RD
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-7939
Country	:	US
Telephone Number	:	972-981-3365
Fax Number	:

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	03/19/2012

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