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NPI Code Detail

MEDICARE: MACKENZIE GUIZIO-CROCKETT CRNA

MEDICARE: MACKENZIE GUIZIO-CROCKETT 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 Anesthetist3006889KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P01189418OTHERKYRAILROAD MEDICARE

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 : 1427347814
Entity Type Code : Individual
Provider Name (Legal Business Name) : MACKENZIE GUIZIO-CROCKETT CRNA
Provider Business Mailing Address
First Line : 100 MEDICAL CENTER DR
Second Line :
City : PRINCETON
State : KY
Zip : 42445-2430
Country : US
Telephone Number : 270-365-0300
Fax Number :
Provider Business Practice Location Address
First Line : 100 MEDICAL CENTER DR
Second Line :
City : PRINCETON
State : KY
Zip : 42445-2430
Country : US
Telephone Number : 270-365-0300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2011
Last Update Date : 01/08/2020

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Directions to “ MACKENZIE GUIZIO-CROCKETT CRNA” Practice Location

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