Individual
CAILEY SCRUGGS KOONCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
101 SIVLEY RD SW, HUNTSVILLE, AL 35801-4421
(256) 265-9639
(256) 265-7767
Mailing address
101 SIVLEY RD SW, HUNTSVILLE, AL 35801-4421
(256) 265-9639
(256) 265-7767
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-109346
AL
367500000X
Certified Registered Nurse Anesthetist
811702
TX
367500000X
Certified Registered Nurse Anesthetist
ARNP9297226
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001796600
—
FL
05
—
115859
—
AL
01
—
592-10007
BLUE CROSS BLUE SHIELD
AL
01
—
Y02CP
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/11/2010
Last updated
08/05/2016
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