Individual
JON C WEBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R030913-0600
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0714709
—
IA
01
—
307G8WE
MN BLUE CROSS PROV #
MN
05
—
460224743-48
—
NE
01
—
4994704
SD BLUE CROSS PROV #
SD
05
—
5754750
—
SD
05
—
5754754
—
SD
01
—
RO30913
DAKOTACARE PROV #
SD
Enumeration date
08/13/2006
Last updated
03/07/2008
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