Matthew Lamar Mccoucha, CRNA NURSE ASSISTANT
NPI #1902872062 in Great Lakes, Illinois
Provider Information
- NPI Number
- 1902872062
- Entity Type
- Individual
- Name
- Matthew Lamar Mccoucha, CRNA NURSE ASSISTANT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Nurse Anesthetist, Certified Registered
- Credential
- CRNA NURSE ASSISTANT
- Enumeration Date
- Feb 27, 2006
- Last Updated
- Dec 9, 2009
Practice Location
- Address
- NAVAL HOSPITAL GREAT LAKES, 3001 A 6TH STREET
- City
- Great Lakes
- State
- Illinois
- ZIP Code
- 60088
- Phone
- (847) 688-3450
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Anesthetist, Certified Registered |
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