| Brett Dyer, CRNA | |
|
20208 Deer Path Ct., Goshen, IN 46528 | |
| (801) 864-0218 | |
| Not Available |
| Full Name | Brett Dyer |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 20208 Deer Path Ct., Goshen, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972981140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 28219068A (Indiana) | Primary |
| Entity Name | Memorial Hospital Of Converse County |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356496491 PECOS PAC ID: 2264340843 Enrollment ID: O20031203000672 |
| Entity Name | Community Hospital |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1669410643 PECOS PAC ID: 6608784194 Enrollment ID: O20061104000311 |
| Entity Name | Frontier Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568815843 PECOS PAC ID: 6507147717 Enrollment ID: O20170503001594 |
| Mailing Address | Practice Location Address |
|---|---|
| Brett Dyer, CRNA 20208 Deer Path Ct., Goshen, IN 46528 Ph: (801) 864-0218 | Brett Dyer, CRNA 20208 Deer Path Ct., Goshen, IN 46528 Ph: (801) 864-0218 |
Derek S Poulson, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 57809 Hillside Dr, Goshen, IN 46528 Phone: 801-623-7813 | |
Janice Moore, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 200 High Park Ave, Goshen, IN 46526 Phone: 317-340-8384 |