Dr Kelley Larson Etheridge, APRN/CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Glastonbury, Connecticut. Her current practice location is
195 Eastern Blvd, Glastonbury, Connecticut. You can reach out to her office (for appointments etc.) via phone at
(860) 667-9542.
Dr Kelley Larson Etheridge is licensed to practice in Connecticut (license number 7675) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1821574310.
Provider's Profile
| Full Name | Dr Kelley Larson Etheridge |
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| Gender | Female |
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| Speciality | |
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| Experience | Years |
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| Location | 195 Eastern Blvd, Glastonbury, Connecticut |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Kelley Larson Etheridge attended and graduated from in
NPI Data:
- NPI Number: 1821574310
- Provider Enumeration Date: 07/17/2018
- Last Update Date: 04/16/2025
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Dr Kelley Larson Etheridge such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1821574310 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 7675 (Connecticut) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kelley Larson Etheridge is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Kelley Larson Etheridge, APRN/CRNA
88 Black Walnut Dr,
Durham, CT 06422-1400
Ph: (860) 575-2052 | Dr Kelley Larson Etheridge, APRN/CRNA
195 Eastern Blvd,
Glastonbury, CT 06033-4312
Ph: (860) 667-9542 |
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