Individual
GUISHU FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
250 S 21ST ST, EASTON, PA 18042-3851
(610) 250-4303
(610) 250-4804
Mailing address
PO BOX 650782, DALLAS, TX 75265-0782
(302) 733-0806
(302) 733-0854
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN327139L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072055
AANA #
PA
05
—
102305810
—
PA
01
—
3739532000
IBC
PA
01
—
444601-1
REGISTERED PROFESSIONAL NURSE
NY
01
—
FA2091090
HIGHMARK BLUE SHIELD
PA
01
—
P00724820
RAILROAD MEDICARE PTAN
PA
Enumeration date
06/09/2005
Last updated
07/10/2012
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