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NPI Code Detail

MEDICARE: JOANNE D CHILTON CRNA

MEDICARE: JOANNE D CHILTON 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 AnesthetistRN-164149-LPA

General Provider Information

NPI Number : 1578569307
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNE D CHILTON CRNA
Provider Business Mailing Address
First Line : PO BOX 8500-1776
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19178-0001
Country : US
Telephone Number : 201-804-2800
Fax Number :
Provider Business Practice Location Address
First Line : 2301 E ALLEGHENY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19134-4427
Country : US
Telephone Number : 215-291-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 07/08/2007

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