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NPI Code Detail

MEDICARE: MS. DAWN MARIE MUTH CRNA

MEDICARE: MS. DAWN MARIE MUTH 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 Anesthetist0024165057VA

General Provider Information

NPI Number : 1598786998
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DAWN MARIE MUTH CRNA
Provider Business Mailing Address
First Line : 5500 CREEK CROSSING DR
Second Line :
City : MIDLOTHIAN
State : VA
Zip : 23112-3147
Country : US
Telephone Number : 804-744-0143
Fax Number :
Provider Business Practice Location Address
First Line : 2 BERNARDINE DR
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23602-4404
Country : US
Telephone Number : 757-886-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2006
Last Update Date : 07/08/2007

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