Individual
MR. JOHN A CRENSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4655 MANORLAKE DR, MASON, OH 45040-9016
(513) 398-2198
Mailing address
4655 MANORLAKE DR, MASON, OH 45040-9016
(513) 398-2198
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
170575
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
02034
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000246656
ANTHEM BLUE SHIELD
—
05
—
0966272
—
OH
05
—
200404270
—
IN
01
—
728004
BUCKEYE
—
05
—
74005398
—
KY
Enumeration date
02/09/2006
Last updated
10/06/2009
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