1992703755 NPI number — MS. BARBARA MURTAGH CRNA

Table of content: MS. BARBARA MURTAGH CRNA (NPI 1992703755)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992703755 NPI number — MS. BARBARA MURTAGH CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MURTAGH
Provider First Name:
BARBARA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992703755
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10951 GULF SHORE DR
Provider Second Line Business Mailing Address:
301
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34108-1744
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-509-2088
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10951 GULF SHORE DR
Provider Second Line Business Practice Location Address:
301
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34108-1744
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-509-2088
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/14/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  133277 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00478844 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 3077750100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: G4029 . This is a "BCBS" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".