Nicole Letellier, | |
5300 N Meadows Dr, Grove City, OH 43123-2546 | |
(614) 663-5000 | |
Not Available |
Full Name | Nicole Letellier |
---|---|
Gender | Female |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 5300 N Meadows Dr, Grove City, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063114874 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | RN.441706 (Ohio) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 0020852 (Ohio) | Primary |
Entity Name | Premier Anesthesia Of Ohio Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1699196022 PECOS PAC ID: 3779714258 Enrollment ID: O20140326001267 |
Mailing Address | Practice Location Address |
---|---|
Nicole Letellier, 366 King Ave Apt A, Columbus, OH 43201-2616 Ph: (419) 618-1253 | Nicole Letellier, 5300 N Meadows Dr, Grove City, OH 43123-2546 Ph: (614) 663-5000 |
Clayton Roush, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2977 Orders Rd, Grove City, OH 43123 Phone: 304-593-8209 | |
Randall Kinietz, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 5300 N Meadows Dr, Grove City, OH 43123 Phone: 614-663-5000 | |
Jacob Deemer, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1649 Nature Dr, Grove City, OH 43123 Phone: 724-809-1042 |