Individual
ERIC DANE ALBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2829
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2013007659
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184965212
—
MO
05
—
197989001
—
AR
01
—
431560263
TRI CARE
MO
01
—
P01196869
MCR RR
MO
Enumeration date
03/14/2013
Last updated
10/15/2021
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