Individual
SUSAN ANNICELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
USA MEDDAC, RWBAHC, 2240E. WINROW AVE, FORT HUACHUCA, AZ 85613-7079
(520) 533-9026
Mailing address
1518 GRIERSON AVE, FORT HUACHUCA, AZ 85613
(520) 533-9026
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
108867
NC
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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