Individual
KELLY R CREMEANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
100 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(855) 446-5937
(740) 441-8058
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5238
(740) 441-8058
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
NA-09757
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000229730
OH MEDICAID UNISON
OH
05
—
2793562
—
OH
05
—
3810010721
—
WV
01
—
CR241011
MEDICARE
OH
01
—
P00457804
RAILROAD MEDICARE
OH
Enumeration date
12/04/2007
Last updated
01/21/2021
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