Unknown Individual – Certified Registered Nurse Anesthetist, NPI 1194767202
Certified Registered Nurse Anesthetist
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
PO BOX 795142
ST LOUIS, MO 63179
Phone: (309) 662-4321
Fax: (309) 661-4532
Type: Mailing
1015, South Mercer Avenue, Bloomington, McLean County, Illinois, 61701, United States
BLOOMINGTON, IL 61701
Phone: (309) 662-4321
Fax: (309) 661-4532
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63179)
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