Individual
MR. ALDIN JOHN PELICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
415 N MAIN ST, ULYSSES, KS 67880-2133
(620) 356-1266
(620) 424-6313
Mailing address
PO BOX 913041, DENVER, CO 80291-3041
(610) 594-5108
(610) 363-1790
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1-081210
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
43-55702
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015113326
—
AL
05
—
105336
—
AL
01
—
CN0216
MEDICARE TRAVELERS
AL
01
—
P00380505
MEDICARE TRAVERLERS ID
AL
Enumeration date
07/27/2006
Last updated
11/13/2018
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