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NPI Code Detail

MEDICARE: WARREN GOUNER CRNA

MEDICARE: WARREN GOUNER 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 AnesthetistR63072AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
25U360OTHERARBLUE CROSS OF AR

General Provider Information

NPI Number : 1619932233
Entity Type Code : Individual
Provider Name (Legal Business Name) : WARREN GOUNER CRNA
Provider Business Mailing Address
First Line : 400 E 10TH ST
Second Line :
City : WACONIA
State : MN
Zip : 55387-4552
Country : US
Telephone Number : 952-442-9770
Fax Number : 952-442-3630
Provider Business Practice Location Address
First Line : 1015 UNITY RD
Second Line : HWY 82E
City : CROSSETT
State : AR
Zip : 71635-9443
Country : US
Telephone Number : 870-364-1280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2006
Last Update Date : 04/29/2008

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Directions to “ WARREN GOUNER CRNA” Practice Location

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