Mr Dennis W Tracy, CRNA | |
701 Lewiston St, Cottonwood, ID 83522 | |
(208) 962-3251 | |
(208) 962-3722 |
Full Name | Mr Dennis W Tracy |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 701 Lewiston St, Cottonwood, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1578612065 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | RNA201 (Idaho) | Primary |
Entity Name | St. Mary's Hospital, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841292307 PECOS PAC ID: 5092773168 Enrollment ID: O20050316000814 |
Entity Name | Clearwater Valley Hospital & Clinics |
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Entity Type | Part A Provider - Rural Health Clinic |
Entity Identifiers | NPI Number: 1033153739 PECOS PAC ID: 0547173346 Enrollment ID: O20050628000452 |
Mailing Address | Practice Location Address |
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Mr Dennis W Tracy, CRNA 701 Lewiston St, Cottonwood, ID 83522 Ph: (208) 962-3251 | Mr Dennis W Tracy, CRNA 701 Lewiston St, Cottonwood, ID 83522 Ph: (208) 962-3251 |
Todd K. Mcallister, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 701 Lewiston St, Cottonwood, ID 83522 Phone: 208-962-3267 | |
Kevin Lienesch, DNP, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 701 Lewiston St, Cottonwood, ID 83522 Phone: 208-962-3251 |