Individual
MARLENE LOUISE LOVENGUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4921 E BELL RD STE 102, SCOTTSDALE, AZ 85254-6002
(602) 787-9100
(602) 508-4830
Mailing address
94220 4TH ST, GOLD BEACH, OR 97444-7756
(541) 247-3000
(541) 247-3151
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
082012257CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
228702
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201074
DMAP
OR
01
—
381322
CURRY GENERAL HOSPITAL'S MEDICARE PART A
OR
01
—
R0000ZGBDG
CURRY GENERAL HOSPITAL MEDICARE PART B
OR
Enumeration date
06/30/2006
Last updated
08/27/2021
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