Organization Name: | MONTGOMERY REGIONAL HOSPITAL--CRNA |
NPI Number: | 1356420673 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEBRA A WICKLINE (PATIENT ACCESS SUPVR) |
Mailing Address: | 3700 S Main St Blacksburg |
State: | VA US |
Postal Code: | 240607017 |
Phone Number: | 5409535123 |
Fax Number: | 5409614673 |
NPI Enumeration Date: | 11/06/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 0024097342 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |