Individual
FELICIA B SCACEWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA0507
AZ
367500000X
Certified Registered Nurse Anesthetist
RN086691
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202253
—
AZ
01
—
P00466238
RAILROAD MEDICARE
AZ
Enumeration date
04/04/2007
Last updated
10/04/2021
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