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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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