MEDICARE: PATRICIA ANNE COONEY 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	RN177057L	PA

General Provider Information

NPI Number	:	1720036023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA ANNE COONEY CRNA

Provider Business Mailing Address
First Line	:	205 NEWTOWN RD
Second Line	:	SUITE 208
City	:	WARMINSTER
State	:	PA
Zip	:	18974-5207
Country	:	US
Telephone Number	:	215-773-9564
Fax Number	:	215-773-9602

Provider Business Practice Location Address
First Line	:	225 NEWTOWN RD
Second Line	:
City	:	WARMINSTER
State	:	PA
Zip	:	18974-5221
Country	:	US
Telephone Number	:	215-773-9564
Fax Number	:	215-773-9602

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

Provider Enumeration Date	:	05/05/2006
Last Update Date	:	06/18/2008

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