Kevin Liebrum, CRNA | |
1515 N Madison Ave, Anderson, IN 46011-3453 | |
(317) 802-6302 | |
Not Available |
Full Name | Kevin Liebrum |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 1515 N Madison Ave, Anderson, Indiana |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649252586 | NPI | - | NPPES |
200387980 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 28154851 (Indiana) | Primary |
Entity Name | Community Physicians Of Indiana Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1619105244 PECOS PAC ID: 1759416662 Enrollment ID: O20100317000717 |
Mailing Address | Practice Location Address |
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Kevin Liebrum, CRNA 6626 E 75th St, Suite 500, Indianapolis, IN 46250-2805 Ph: () - | Kevin Liebrum, CRNA 1515 N Madison Ave, Anderson, IN 46011-3453 Ph: (317) 802-6302 |
Krysta Ramey, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2015 Jackson St, Anderson, IN 46016 Phone: 765-649-2500 | |
Brandon Johnston, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2015 Jackson St, Anderson, IN 46016 Phone: 765-649-2511 | |
Kathrine Annette Miller, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1515 N Madison Ave, Anderson, IN 46011 Phone: 765-298-2928 | |
Brittney Leigh Schiller, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2015 Jackson St, Anderson, IN 46016 Phone: 765-649-2511 | |
Jerri Goodman, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1515 N Madison Ave, Anderson, IN 46011 Phone: 317-802-6302 | |
Gregory A Yant, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1515 N Madison Ave, Anderson, IN 46011 Phone: 765-298-4242 | |
Amanda Christine Huddleston, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2015 Jackson St, Anderson, IN 46016 Phone: 765-649-2511 |