Kevin Hal Liljenquist, | |
444 Four States Dr Ste 2, Galena, KS 66739-4325 | |
(620) 783-4000 | |
Not Available |
Full Name | Kevin Hal Liljenquist |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 2 Years |
Location | 444 Four States Dr Ste 2, Galena, Kansas |
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 |
---|---|---|---|
1952041790 | NPI | - | NPPES |
910110875 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 2022021647 (Missouri) | Primary |
163W00000X | Registered Nurse | 2017026396 (Missouri) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Mercy Specialty Hospital Southeast Kansas | Galena, KS | Hospital |
Cox Medical Center Branson | Branson, MO | Hospital |
Mercy Hospital Carthage | Carthage, MO | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Lester E Cox Medical Centers | 1658509864 | 34 |
Mercy Hospital Carthage | 8426225251 | 19 |
Four States Anesthesia Services Llc | 8729973284 | 20 |
Four States Anesthesia Services Llc | 8729973284 | 20 |
Entity Name | Four States Anesthesia Services Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053382929 PECOS PAC ID: 8729973284 Enrollment ID: O20040216000537 |
Entity Name | Mercy Hospital Carthage |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003201955 PECOS PAC ID: 8426225251 Enrollment ID: O20120225000071 |
Entity Name | Lester E Cox Medical Centers |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1174952212 PECOS PAC ID: 1658509864 Enrollment ID: O20140115001602 |
Entity Name | Mercy Hospital Carthage |
---|---|
Entity Type | Part A Provider - Critical Access Hospital |
Entity Identifiers | NPI Number: 1003201955 PECOS PAC ID: 8426225251 Enrollment ID: O20141203001963 |
Mailing Address | Practice Location Address |
---|---|
Kevin Hal Liljenquist, Po Box 802843, Kansas City, MO 64180-2843 Ph: () - | Kevin Hal Liljenquist, 444 Four States Dr Ste 2, Galena, KS 66739-4325 Ph: (620) 783-4000 |
Danielle R Jackson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 444 Four States Dr, Suite 2, Galena, KS 66739 Phone: 620-783-4441 | |
Mr. Keanon Walker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 444 Four States Dr, Suite 2, Galena, KS 66739 Phone: 620-783-4000 Fax: 620-783-4188 | |
Jonathan Bryan Sperry, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 444 Four States Dr, Suite 1, Galena, KS 66739 Phone: 620-783-4000 |