| Lisa Brokaw, CRNA | |
|
2600 Sixth St Sw, Ohio Hospital Based Physician Corp, Canton, OH 44710 | |
| (330) 363-7462 | |
| (330) 363-7679 |
| Full Name | Lisa Brokaw |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 2600 Sixth St Sw, Canton, Ohio |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851352652 | NPI | - | NPPES |
| 0803447 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN166143 (Ohio) | Primary |
| Entity Name | Aultman Deuble Heart & Vascular Hospital, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306495718 PECOS PAC ID: 1850726126 Enrollment ID: O20200114002347 |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa Brokaw, CRNA 2600 Sixth St Sw, Ohio Hospital Based Physician Corp, Canton, OH 44710 Ph: (330) 363-7462 | Lisa Brokaw, CRNA 2600 Sixth St Sw, Ohio Hospital Based Physician Corp, Canton, OH 44710 Ph: (330) 363-7462 |
Sarah Gomez, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4665 Douglas Cir Nw, Canton, OH 44718 Phone: 330-499-5700 | |
Roxie Lee Rush, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2600 Sixth Street Sw, Ohio Hospital Based Physician Corp, Canton, OH 44710 Phone: 330-363-7462 Fax: 330-363-7679 | |
Mr. Kevin White, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2600 Sixth St Sw, Canton, OH 44710 Phone: 330-363-7462 Fax: 330-363-7679 | |
Amanda G Gillis, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 4665 Douglas Cir Nw, #100, Canton, OH 44718 Phone: 330-499-5700 Fax: 330-498-4229 | |
Arlene Ann Weeber, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2600 6th St Sw, Ohio Hospital Based Physician Corp, Canton, OH 44710 Phone: 330-363-7462 Fax: 330-363-7679 | |
Sheree Boyle, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2600 Sixth St Sw, Canton, OH 44710 Phone: 330-363-7462 Fax: 330-363-7679 | |
Lois R Milosevic, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1320 Mercy Dr Nw, Canton, OH 44708 Phone: 330-489-1111 |