Paul Wendell Nicholson, CRNA | |
201 Canyon Crest Dr, Twin Falls, ID 83301-5934 | |
(208) 734-7362 | |
Not Available |
Full Name | Paul Wendell Nicholson |
---|---|
Gender | Male |
Speciality | Certified Registered Nurse Anesthetist (crna) |
Experience | 6 Years |
Location | 201 Canyon Crest Dr, Twin Falls, Idaho |
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 |
---|---|---|---|
1265997985 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
367500000X | Nurse Anesthetist, Certified Registered | 8752157-4406 (Utah) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | 69350 (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Luke's Wood River Medical Center | Ketchum, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
St Lukes Clinic - Wood River Llc | 3173783818 | 54 |
Entity Name | St Lukes Clinic - Wood River Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1972891604 PECOS PAC ID: 3173783818 Enrollment ID: O20120404000474 |
Mailing Address | Practice Location Address |
---|---|
Paul Wendell Nicholson, CRNA 201 Canyon Crest Dr Ste 100, Twin Falls, ID 83301-5935 Ph: () - | Paul Wendell Nicholson, CRNA 201 Canyon Crest Dr, Twin Falls, ID 83301-5934 Ph: (208) 734-7362 |
Mr. Chet Dansie, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1000 | |
Daniel Scott Johnson, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-734-7362 Fax: 208-814-0948 | |
Brendan Petersen, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1000 | |
John Brandon Cory, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1000 | |
Robert Kinghorn, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 115 Falls Ave W, Twin Falls, ID 83301 Phone: 208-734-7362 Fax: 208-733-9463 | |
David A White, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-1000 Fax: 208-814-7528 | |
Jason Rojas, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 801 Pole Line Rd W, Twin Falls, ID 83301 Phone: 208-814-2400 |