Provider Demographics
NPI:1356432397
Name:TACCHI, ERNEST JOHN (CRNA)
Entity type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:JOHN
Last Name:TACCHI
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
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Mailing Address - Street 1:151 TUTHILL LN
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1401
Mailing Address - Country:US
Mailing Address - Phone:251-342-6168
Mailing Address - Fax:251-380-9309
Practice Address - Street 1:2451 FILLINGIM ST
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36617-2238
Practice Address - Country:US
Practice Address - Phone:251-471-7045
Practice Address - Fax:251-471-7042
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-045811367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered