Individual
JED RIVERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
205 E PALMER RD, BELLEFONTAINE, OH 43311
(937) 592-4015
(937) 292-7148
Mailing address
205 E PALMER RD, BELLEFONTAINE, OH 43311-2281
(937) 592-4015
(937) 292-7148
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
67562
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.17745
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001861465
MTN STATE BCBS
WV
05
—
2667298
—
OH
05
—
3810005650
—
WV
Enumeration date
09/20/2006
Last updated
08/20/2024
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