Lisa Diane Blacketter, CRNA | |
2701 Hospital Dr, Victoria, TX 77901-5749 | |
(361) 573-9181 | |
(361) 582-5743 |
Full Name | Lisa Diane Blacketter |
---|---|
Gender | Female |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 12 Years |
Location | 2701 Hospital Dr, Victoria, Texas |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1851630040 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 209010216 (Illinois) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Memorial Medical Center | Port lavaca, TX | Hospital |
De Tar Hospital Navarro | Victoria, TX | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Citizens Medical Center County Of Victoria | 3577785096 | 85 |
Entity Name | Citizens Medical Center County Of Victoria |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205242088 PECOS PAC ID: 3577785096 Enrollment ID: O20141117000499 |
Mailing Address | Practice Location Address |
---|---|
Lisa Diane Blacketter, CRNA 2701 Hospital Dr, Victoria, TX 77901-5749 Ph: (361) 573-9181 | Lisa Diane Blacketter, CRNA 2701 Hospital Dr, Victoria, TX 77901-5749 Ph: (361) 573-9181 |
Kristina Alexis Whiteley, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2701 Hospital Dr, Victoria, TX 77901 Phone: 361-582-5728 | |
Ralph Smith, C.R.N.A. Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1501 E Mockingbird Ln, #101, Victoria, TX 77904 Phone: 361-513-6291 Fax: 361-576-2434 | |
Daniel Schlichting, C.R.N.A. Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1501 E Mockingbird Ln Ste 220, Victoria, TX 77904 Phone: 361-573-2481 Fax: 361-576-2434 | |
Danielle Burns, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 2701 Hospital Dr, Victoria, TX 77901 Phone: 361-573-9181 | |
David J Solis, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1501 E Mockingbird Ln, Suite 220, Victoria, TX 77904 Phone: 361-573-6291 Fax: 361-576-2434 | |
Sara A Dornbusch, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2701 Hospital Dr, Victoria, TX 77901 Phone: 361-573-9181 | |
Mrs. Natalie Dawn Chilton, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1501 E Mockingbird Lane, #220, Victoria, TX 77904 Phone: 361-573-6291 |