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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

SOUPHAPHONE BOUNMYTHAVONG NICKSIC, CRNA

Active

SOUPHAPHONE BOUNMYTHAVONG NICKSIC, CRNA is a Certified Nurse Anesthetist (CRNA) healthcare provider located in ELGIN, Illinois. NPI 1740425701 is currently active in the NPPES registry. Verify at CMS.

Certified Nurse Anesthetist (CRNA) · ELGIN, IL

Registration Details

NPI Number
1740425701
Provider Type
Individual
Gender
Female
NPI Issued
Dec 4, 2008 (17.738610962168 yrs)
Last Updated
Aug 30, 2023
Licenses
28181986A (IN)
209008677 (IL)

Practice Information

Address
1425 N RANDALL RD
ELGIN, IL, 601232300
Browse IL providers · Browse ZIP 60123
Phone
2247831065
Fax
2247832852
Primary Specialty
Certified Nurse Anesthetist (CRNA)
367500000X

Other Certified Nurse Anesthetist (CRNA) Providers in ELGIN, IL

Name Credential NPI
JOAN YOUNG CRNA 1518925544
JANINE A. GOODSITE CRNA 1093763070
LAURA J SOSTAK CRNA 1134230808
STEVE URBANE CRNA 1790889111
DANIELLE M NAKHSHIN CRNA 1942510151
STACY JONES CRNA 1780952010
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.