Phillip Conwell CRNA

NPI 1255540340 - Registered Nurse - 163W00000X

NPI Details
NPI 1255540340
Gender Male
Enumeration Date 05/22/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
700 RIVER DR
FORT BRAGG CA, 95437-5403, US
Phone (707) 961-1234
Fax
Business Location
PO BOX 34120
RENO NV, 89533-4120, US
Phone (775) 747-5050
Fax (775) 747-5005
Toxanomy
Taxonomy Code 163W00000X
License State California
License Number RN405621
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According to our database, Phillip Conwell CRNA NPI is 1255540340, taxonomy code is 163W00000X and license number is RN405621, license state is located at California. Phillip Conwell CRNA physically located at 700 River Dr, Fort Bragg CA, 95437-5403. NPI Number Phillip Conwell CRNA has the Individual type.

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1255540340 NPI number is provided on an as is basis without warranty of any kind. 1255540340 is maintained by the National Plan & Provider Enumeration System. The contents of Phillip Conwell CRNA are for informational purposes only.