Individual
VERNON R ROUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5238
(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
189508
OH
367500000X
Certified Registered Nurse Anesthetist
25495
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000204786
OH MEDICAID UNISON
OH
05
—
0067573000
—
WV
05
—
0752127
—
OH
Enumeration date
07/21/2006
Last updated
11/25/2020
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