Aaron M Petersen, CRNA | |
3125 Dr Russell Smith Way, Anesthesia Dept, Carthage, MO 64836-7402 | |
(417) 358-8121 | |
(417) 237-7240 |
Full Name | Aaron M Petersen |
---|---|
Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 3125 Dr Russell Smith Way, Carthage, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982680666 | NPI | - | NPPES |
200316420A | Medicaid | KS | |
35425022 | Other | MO | BLUE CROSS BLUE SHIELD OF KANSAS CITY |
917230708 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 2008010327 (Missouri) | Primary |
Entity Name | Kansas Institute Of Medicine |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1699100917 PECOS PAC ID: 3274762448 Enrollment ID: O20140210001760 |
Mailing Address | Practice Location Address |
---|---|
Aaron M Petersen, CRNA 3125 Dr Russell Smith Way, Anesthesia Dept, Carthage, MO 64836-7402 Ph: (417) 358-8121 | Aaron M Petersen, CRNA 3125 Dr Russell Smith Way, Anesthesia Dept, Carthage, MO 64836-7402 Ph: (417) 358-8121 |
Edward Dean Messer, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3125 Dr Russell Smith Way, Carthage, MO 64836 Phone: 417-359-2653 Fax: 417-358-4612 | |
Robert Edward Koch, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 3125 Dr Russell Smith Way, Carthage, MO 64836 Phone: 417-359-2653 Fax: 417-358-4612 | |
Donald Edward Beissel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 627 West Centennial, Carthage, MO 64836 Phone: 417-358-8121 Fax: 417-237-7240 |