Individual
CONNIE COUSINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
334 FULLINGMILL RD, MERCER, PA 16137-2006
(724) 699-5313
(724) 662-9296
Mailing address
334 FULLINGMILL RD, MERCER, PA 16137-2006
(724) 699-5313
(724) 662-9296
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
113654
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0814766
—
OH
Enumeration date
10/13/2005
Last updated
07/08/2007
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