Individual
NARDY STASCAVAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163WX0800X
Orthopedic Registered Nurse
Primary
9568
MT
207L00000X
Anesthesiology Physician
9568
MT
Other
Enumeration date
09/24/2012
Last updated
09/24/2012
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