Organization
MIDWEST KETAFUSION LLC
Active
Organization
MIDWEST KETAFUSION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLIE HONG CRNA, ARNP (NURSE ANESTHETIST)
(319) 331-4391
Entity
Organization
Contact information
Practice address
1700 S 1ST AVE STE 25A, IOWA CITY, IA 52240-6036
(319) 849-8114
(319) 333-0624
Mailing address
1700 S 1ST AVE STE 25A, IOWA CITY, IA 52240-6036
(319) 849-8114
(319) 333-0624
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
163WI0500X
Infusion Therapy Registered Nurse
—
—
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
—
—
163WP0808X
Psychiatric/Mental Health Registered Nurse
—
—
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
—
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
11/04/2020
Last updated
04/25/2023
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