MEDICARE: AMY L MADDEN 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	ARNP9209715	FL

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	:	1851370761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY L MADDEN CRNA

Provider Business Mailing Address
First Line	:	8383 N DAVIS HWY
Second Line	:	WEST FLORIDA ANESTHESIA SERVICE, LLC
City	:	PENSACOLA
State	:	FL
Zip	:	32514-6039
Country	:	US
Telephone Number	:	850-474-8319
Fax Number	:	850-969-2958

Provider Business Practice Location Address
First Line	:	8383 N DAVIS HWY
Second Line	:	WEST FLORIDA ANESTHESIA SERVICE, LLC
City	:	PENSACOLA
State	:	FL
Zip	:	32514-6039
Country	:	US
Telephone Number	:	850-474-8319
Fax Number	:	850-969-2958

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

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	04/08/2008

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