Austin Wilson, | |
1355 Bogue St, East Lansing, MI 48824-6207 | |
(800) 605-6424 | |
Not Available |
Full Name | Austin Wilson |
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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 |
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367500000X | Nurse Anesthetist, Certified Registered | 4704329076 (Michigan) | Primary |
Entity Name | Edward W Sparrow Hospital Association |
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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 |
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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: Medicare Enrolled 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 | |
Kalin Elizabeth Green, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 444 Avocet Dr, East Lansing, MI 48823 Phone: 770-377-1256 |