MEDICARE: TRANQUIL TRANSITIONS

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	518261	TX

General Provider Information

NPI Number	:	1932373123
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRANQUIL TRANSITIONS

Provider Business Mailing Address
First Line	:	8408 TYHURST DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78749-3522
Country	:	US
Telephone Number	:	512-751-0753
Fax Number	:

Provider Business Practice Location Address
First Line	:	3201 HIGHWAY 71 E
Second Line	:
City	:	BASTROP
State	:	TX
Zip	:	78602-5126
Country	:	US
Telephone Number	:	512-321-8269
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CAROL OSBORNE LUCAS
Credential	:	CRNA
Telephone Number	:	512-751-0753

Provider Enumeration Date	:	04/17/2008
Last Update Date	:	04/17/2008

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Directions to “TRANQUIL TRANSITIONS ” Practice Location

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