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RUSSELL STAGG CRNA

>> Registered Nurse >> Nursing Service Providers

Registrant NPI Number: 1720356496

Individual Registrant:
 RUSSELL  STAGG CRNA
Gender: M
Sole Proprietor

Location and contact information for practice:
100 PMC DR  MEEKER, CO 81641-3181 US
Tel: 970-878-9740  Fax: --

Contact information for business:
PO BOX 2541  MEEKER, CO 81641-2541 US
Tel: 801-803-3106  Fax: --

Registration Information:
NPI: 1720356496
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N163W00000XNursing Service Providers
Registered Nurse
UT6154226-3102
Y367500000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Anesthetist, Certified Registered
MO2012001556

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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