Kellie Logue, CRNA | |
214 S 4th St, Kremmling, CO 80459-5065 | |
(970) 887-5800 | |
Not Available |
Full Name | Kellie Logue |
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Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 214 S 4th St, Kremmling, Colorado |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275940496 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 185347 (Tennessee) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | APN.0993708-CRNA (Colorado) | Primary |
Entity Name | The Memorial Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063418424 PECOS PAC ID: 1254231533 Enrollment ID: O20040112000299 |
Entity Name | Kremmling Memorial Hospital District |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619962321 PECOS PAC ID: 7517871544 Enrollment ID: O20040312001110 |
Entity Name | Southern Colorado Crna Associates Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043538382 PECOS PAC ID: 3072785559 Enrollment ID: O20111005000146 |
Entity Name | Arkansas Valley Regional Medical Center |
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Entity Type | Part B Supplier - Hospital Department(s) |
Entity Identifiers | NPI Number: 1609320514 PECOS PAC ID: 9436062833 Enrollment ID: O20180205002945 |
Entity Name | 444 Wellness Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619600285 PECOS PAC ID: 6204211998 Enrollment ID: O20220915003690 |
Mailing Address | Practice Location Address |
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Kellie Logue, CRNA Po Box 399, Kremmling, CO 80459-0399 Ph: (309) 202-1692 | Kellie Logue, CRNA 214 S 4th St, Kremmling, CO 80459-5065 Ph: (970) 887-5800 |