Jeffrey R Johannsen, CRNA | |
1027 Washington Ave, Detroit Lakes, MN 56501-3409 | |
(218) 847-5611 | |
(218) 847-0881 |
Full Name | Jeffrey R Johannsen |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 23 Years |
Location | 1027 Washington Ave, Detroit Lakes, Minnesota |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1730125816 | NPI | - | NPPES |
033G2JO | Other | MN | MNBS # |
1697627 | Other | MN | AMERICA'S PPO/ARAZ # |
1730125816 | Medicaid | MN | |
23758 | Other | MN | NDBS # |
DA9031034432 | Other | MN | PREFERRED ONE # |
12694 | Medicaid | MN | |
2001891 | Other | MN | MEDICA # |
24174 | Other | MN | LHS/BANNERHEALTH # |
HP38479 | Other | MN | HEALTHPARTNERS # |
150582300 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | R141280-4 (Minnesota) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Essentia Health St Marys - Detroit Lakes | Detroit lakes, MN | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
St Marys Regional Health Center | 2062326820 | 159 |
Entity Name | St Marys Regional Health Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1679561088 PECOS PAC ID: 2062326820 Enrollment ID: O20031117000090 |
Mailing Address | Practice Location Address |
---|---|
Jeffrey R Johannsen, CRNA 1027 Washington Ave, Detroit Lakes, MN 56501-3409 Ph: (218) 847-5611 | Jeffrey R Johannsen, CRNA 1027 Washington Ave, Detroit Lakes, MN 56501-3409 Ph: (218) 847-5611 |
Jeffrey D. Sliper, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-847-5611 Fax: 218-847-0881 | |
Kristine K Domier, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-847-5611 Fax: 218-847-0881 | |
Carol M Lee, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-847-5611 Fax: 218-847-0881 | |
Russell H Sauer, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-847-5611 | |
Benjamin B Evenson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1027 Washington Ave, Detroit Lakes, MN 56501 Phone: 218-847-5611 Fax: 218-847-0881 | |
Dewayne M Dunham, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 125 Frazee St E, Detroit Lakes, MN 56501 Phone: 218-844-2300 Fax: 218-844-2444 |