Basic Information
Provider Information
NPI: 1134191109
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TRANCHINE
FirstName: SUSAN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 157
Address2:  
City: GRAPEVILLE
State: PA
PostalCode: 156340157
CountryCode: US
TelephoneNumber: 7245276517
FaxNumber: 7245276519
Practice Location
Address1: 600 JEFFERSON AVE
Address2: MERCY JEANNETTE HOSPITAL
City: JEANNETTE
State: PA
PostalCode: 156440600
CountryCode: US
TelephoneNumber: 7245273551
FaxNumber: 7245276519
Other Information
ProviderEnumerationDate: 02/03/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN245794LPAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

ID Information
IDTypeStateIssuerDescription
RT135583501PABLUE SHIELDOTHER


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