MEDICARE: JAMES RILEY CLAPP 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	120721	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	:	1881693737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES RILEY CLAPP CRNA

Provider Business Mailing Address
First Line	:	2130 LUMBERJACK DR
Second Line	:
City	:	HEBRON
State	:	KY
Zip	:	41048-7925
Country	:	US
Telephone Number	:	859-534-5513
Fax Number	:

Provider Business Practice Location Address
First Line	:	2130 LUMBERJACK DR
Second Line	:
City	:	HEBRON
State	:	KY
Zip	:	41048-7925
Country	:	US
Telephone Number	:	859-534-5513
Fax Number	:

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

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	07/08/2007

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