MEDICARE: WILLIAM MILBURN 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	000609	CT

General Provider Information

NPI Number	:	1558364307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM MILBURN CRNA

Provider Business Mailing Address
First Line	:	99 E RIVER DR
Second Line	:	5TH FLOOR
City	:	EAST HARTFORD
State	:	CT
Zip	:	06108-3288
Country	:	US
Telephone Number	:	860-282-4022
Fax Number	:	860-289-0746

Provider Business Practice Location Address
First Line	:	99 E RIVER DR
Second Line	:	5TH FLOOR
City	:	EAST HARTFORD
State	:	CT
Zip	:	06108-3288
Country	:	US
Telephone Number	:	860-282-4022
Fax Number	:	860-289-0746

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	05/12/2014

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Directions to “ WILLIAM MILBURN CRNA” Practice Location

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