Organization
MACGASGIRL, LLC
Active
Organization
MACGASGIRL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA R MEANEY CRNA (OWNER)
(574) 268-9640
Entity
Organization
Contact information
Practice address
7747 W JEFFERSON BLVD STE B, FORT WAYNE, IN 46804-4135
(260) 434-9104
Mailing address
PO BOX 1296, WARSAW, IN 46581-1296
(574) 268-9640
(574) 268-0684
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28147521A
IN
Other
Enumeration date
03/28/2017
Last updated
04/06/2017
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