Mr John Thayer Edmondson, CRNA | |
2323 Texas St, Pecos, TX 79772-7338 | |
(432) 447-3551 | |
(432) 447-5434 |
Full Name | Mr John Thayer Edmondson |
---|---|
Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 2323 Texas St, Pecos, Texas |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1295799260 | NPI | - | NPPES |
023413 | Other | TN | CRNA CERTIFICATION NUMBER |
202890402 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | RN043542 (Tennessee) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | AP115284 (Texas) | Primary |
Mailing Address | Practice Location Address |
---|---|
Mr John Thayer Edmondson, CRNA 2323 Texas St, Pecos, TX 79772-7338 Ph: (432) 447-3551 | Mr John Thayer Edmondson, CRNA 2323 Texas St, Pecos, TX 79772-7338 Ph: (432) 447-3551 |
Jerry F Giardina, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2323 Texas St, Pecos, TX 79772 Phone: 432-447-3551 Fax: 432-447-5434 |