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NPI Code Detail

MEDICARE: GLENN CORMIER CRNA

MEDICARE: GLENN CORMIER 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
1367500000XCertified Registered Nurse Anesthetist036468LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427155019
Entity Type Code : Individual
Provider Name (Legal Business Name) : GLENN CORMIER CRNA
Provider Business Mailing Address
First Line : 2644 S SHERWOOD FOREST BLVD
Second Line : STE 121
City : BATON ROUGE
State : LA
Zip : 70816-2248
Country : US
Telephone Number : 225-293-2523
Fax Number : 225-293-1807
Provider Business Practice Location Address
First Line : 8212 KELWOOD AVE
Second Line :
City : BATON ROUGE
State : LA
Zip : 70806-4801
Country : US
Telephone Number : 225-929-7600
Fax Number : 225-930-7524
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2006
Last Update Date : 03/29/2017

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Directions to “ GLENN CORMIER CRNA” Practice Location

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