Individual
DR. JEEVAN BHATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0417
Mailing address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0417
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1-121107
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
2024020912
MO
Other
Enumeration date
07/12/2016
Last updated
01/07/2025
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