Individual
TAYLOR GARY CORRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1200 W MOHAVE RD, LA PAZ REGIONAL HOSPITAL, PARKER, AZ 85344-6349
(928) 669-7311
Mailing address
3309 NEWPORT DR, LAKE HAVASU CITY, AZ 86406-5551
(435) 671-6246
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
179809
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
0948
AZ
Other
Enumeration date
04/23/2012
Last updated
01/20/2015
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