Kimberly K Oliver, CRNA | |
1405 Mill St, New London, WI 54961-2155 | |
(920) 531-2000 | |
Not Available |
Full Name | Kimberly K Oliver |
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Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 1405 Mill St, New London, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1265757843 | NPI | - | NPPES |
ENROLLED | Medicaid | MN | |
P00839047 | Other | MN | RAILROAD MEDICARE |
ENROLLED | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 0191 (Minnesota) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 6607-33 (Wisconsin) | Primary |
Entity Name | Thedacare Medical Center - Shawano, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1548260839 PECOS PAC ID: 5890605836 Enrollment ID: O20031117000117 |
Entity Name | Association Of Hospital Anesthesiologists Sc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720076474 PECOS PAC ID: 3476539875 Enrollment ID: O20050719001050 |
Entity Name | New Anesthesiology Sc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629163894 PECOS PAC ID: 0547269078 Enrollment ID: O20061212000118 |
Mailing Address | Practice Location Address |
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Kimberly K Oliver, CRNA Po Box 2759, Appleton, WI 54912-2759 Ph: (920) 830-5900 | Kimberly K Oliver, CRNA 1405 Mill St, New London, WI 54961-2155 Ph: (920) 531-2000 |
Mr. Michael Reed, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1405 Mill St, New London, WI 54961 Phone: 920-531-2000 Fax: 920-531-2098 |