MEDICARE: GAIL K LARKIN 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	RN-116832	OH

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

General Provider Information

NPI Number	:	1679566509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GAIL K LARKIN CRNA

Provider Business Mailing Address
First Line	:	PO BOX 966
Second Line	:
City	:	LOGAN
State	:	OH
Zip	:	43138-0966
Country	:	US
Telephone Number	:	740-380-8151
Fax Number	:	740-380-8152

Provider Business Practice Location Address
First Line	:	601 STATE ROUTE 664 N
Second Line	:
City	:	LOGAN
State	:	OH
Zip	:	43138-8541
Country	:	US
Telephone Number	:	740-380-8000
Fax Number	:	740-380-8152

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

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	07/08/2007

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Directions to “ GAIL K LARKIN CRNA” Practice Location

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