Organization
MIDWEST ANESTHESIA CORPORATION
Active
Organization
MIDWEST ANESTHESIA CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CYNTHIA D GRESS CRNA (OWNER/PRESIDENT)
(812) 482-9617
Entity
Organization
Contact information
Practice address
602 3RD AVE, JASPER, IN 47546-3601
(812) 482-9617
(812) 634-7152
Mailing address
602 3RD AVE, PO BOX 0488, JASPER, IN 47546-3601
(812) 482-9617
(812) 634-7152
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28080901
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629211057
MIDWEST ANESTHESIA CORPORATION GROUP NPI #
IN
01
—
1982636536
PERSONAL NPI
IN
01
—
261140
MEDICARE PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
IN
01
—
28080901
CRNA MEDICAL LICENSE #
IN
Enumeration date
04/15/2009
Last updated
05/26/2009
Update your record
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