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NPI Code Detail

MEDICARE: MS. MARJORIE JANE CHECCA CRNA

MEDICARE: MS. MARJORIE JANE CHECCA 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 AnesthetistRN204198LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11320058OTHERPABLUE SHIELD
2RN204198LOTHERPARN LICENSE

General Provider Information

NPI Number : 1760435549
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARJORIE JANE CHECCA CRNA
Provider Business Mailing Address
First Line : 810 ALLISON DR
Second Line :
City : INDUSTRY
State : PA
Zip : 15052-1238
Country : US
Telephone Number : 724-643-5514
Fax Number :
Provider Business Practice Location Address
First Line : 2500 HOSPITAL DR
Second Line :
City : ALIQUIPPA
State : PA
Zip : 15001-2123
Country : US
Telephone Number : 724-857-1348
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 12/05/2008

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