| Austin Wilson, | |
|
1355 Bogue St, East Lansing, MI 48824-6207 | |
| (800) 605-6424 | |
| Not Available |
| Full Name | Austin Wilson |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1355 Bogue St, East Lansing, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770286460 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 4704329076 (Michigan) | Primary |
| Entity Name | Edward W Sparrow Hospital Association |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366498107 PECOS PAC ID: 6709799166 Enrollment ID: O20040311001138 |
| Mailing Address | Practice Location Address |
|---|---|
| Austin Wilson, 1355 Bogue St, East Lansing, MI 48824-6207 Ph: () - | Austin Wilson, 1355 Bogue St, East Lansing, MI 48824-6207 Ph: (800) 605-6424 |
Dorletha M Hill, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: Michigan Surgical Center, 2075 Coolidge Road East, East Lansing, MI 48823 Phone: 517-319-9000 | |
Brooke Denae Metiva, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1355 Bogue St, East Lansing, MI 48824 Phone: 800-605-6424 | |
Jaimeson L Rutledge, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1355 Bogue St, East Lansing, MI 48824 Phone: 517-432-8163 | |
Kalin Elizabeth Green, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 444 Avocet Dr, East Lansing, MI 48823 Phone: 770-377-1256 | |
Pablo David Garcia Ortiz, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1355 Bogue St, East Lansing, MI 48824 Phone: 812-629-4423 |