MEDICARE: MR. SCOTT E KAUFFMAN 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	134745	NC
2	367500000X	Certified Registered Nurse Anesthetist	APRN9276267	FL

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437146842
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT E KAUFFMAN CRNA

Provider Business Mailing Address
First Line	:	509 N BRIGHTLEAF BLVD
Second Line	:
City	:	SMITHFIELD
State	:	NC
Zip	:	27577-4407
Country	:	US
Telephone Number	:	919-755-9455
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 BICKETT BLVD
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27608-2567
Country	:	US
Telephone Number	:	919-755-9455
Fax Number	:

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

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	04/15/2019

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