Individual
MR. WILLIAM KENNETH HESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1316 N 10TH ST, SPEARFISH, SD 57783-1530
(605) 642-3113
(605) 642-3117
Mailing address
1316 N 10TH ST, SPEARFISH, SD 57783-1530
(605) 642-3113
(605) 642-3117
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000179
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006915
BCBS
SD
01
—
110048300
MEDICAID
WY
01
—
430058457
RR MEDICARE
—
01
—
438620
MEDICAID
MT
05
—
5750107
—
SD
01
—
9212491
DAKOTA CARE
SD
Enumeration date
07/07/2006
Last updated
07/08/2007
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