Provider Demographics
NPI:1346282316
Name:JAMES, DAVID SCOTT (CRNA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SCOTT
Last Name:JAMES
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 PRAIRIE DR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:WY
Mailing Address - Zip Code:82834-9340
Mailing Address - Country:US
Mailing Address - Phone:307-620-0847
Mailing Address - Fax:
Practice Address - Street 1:33 PRAIRIE DR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:WY
Practice Address - Zip Code:82834-9340
Practice Address - Country:US
Practice Address - Phone:307-620-0847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR45679367500000X
ARC01219367500000X
KYR2925A367500000X
CO165257367500000X
IN28147752A367500000X
TNRN0000129016367500000X
IDRNA-627367500000X
MI4704222647367500000X
MO124907367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
S70318Medicare UPIN