Individual
MATTHEW LAMAR MCCOUCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA NURSE ASSISTANT
Contact information
Practice address
NAVAL HOSPITAL GREAT LAKES, 3001 A 6TH STREET, GREAT LAKES, IL 60088
(847) 688-3450
Mailing address
1040 GULF BREEZE PARKWAY, ANDREWS INSTITUTE FOR ORTHOPAEDICS & SPORTS MEDICINE, GULF BREEZE, FL 32561
(850) 916-8700
(850) 916-8509
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0024140275
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9296655
FL
Other
Enumeration date
02/27/2006
Last updated
12/09/2009
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