Mr Gregory Allan Niderost, | |
1 Madrone St, Willits, CA 95490-4225 | |
(707) 456-3171 | |
Not Available |
Full Name | Mr Gregory Allan Niderost |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 34 Years |
Location | 1 Madrone St, Willits, California |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1255319679 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 1602 (California) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Adventist Health Howard Memorial | Willits, CA | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Willits Hospital Inc | 7416940697 | 45 |
Entity Name | Willits Hospital Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356339543 PECOS PAC ID: 7416940697 Enrollment ID: O20040405000843 |
Mailing Address | Practice Location Address |
---|---|
Mr Gregory Allan Niderost, 1 Madrone St, Willits, CA 95490-4225 Ph: (707) 456-3171 | Mr Gregory Allan Niderost, 1 Madrone St, Willits, CA 95490-4225 Ph: (707) 456-3171 |
Constance Susan Criswell, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Madrone St, Willits, CA 95490 Phone: 707-456-3171 | |
Ms. Debra Jan Wold, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Madrone St, Willits, CA 95490 Phone: 707-456-3171 | |
Dr. Bradley Patrick, CRNA, DNP, MBA, MS Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Madrone St, Willits, CA 95490 Phone: 707-456-3100 |