| Grant Gebhardt, BSN, RN | |
| 
					3215 N Northhills Blvd, Fayetteville, AR 72703-4424  | |
| (479) 463-1000 | |
| Not Available | 
| Full Name | Grant Gebhardt | 
|---|---|
| Gender | Male | 
| Speciality | Nurse Anesthetist, Certified Registered | 
| Location | 3215 N Northhills Blvd, Fayetteville, Arkansas | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1063035038 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 163W00000X | Registered Nurse | R108631 (Arkansas) | Secondary | 
| 367500000X | Nurse Anesthetist, Certified Registered | 230182 (Arkansas) | Primary | 
| Entity Name | Premier Anesthesia Of Arkansas Professional Corporation | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1932519485 PECOS PAC ID: 6406077460 Enrollment ID: O20141016002060  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Grant Gebhardt, BSN, RN 3215 N Northhills Blvd, Fayetteville, AR 72703-4424 Ph: () -  | Grant Gebhardt, BSN, RN 3215 N Northhills Blvd, Fayetteville, AR 72703-4424 Ph: (479) 463-1000  | 
Amanda Lavon Delsoto, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3271 Wimberly Dr, Fayetteville, AR 72703 Phone: 479-713-6100  | |
Kelsey Erin Van Slyke, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 3215 N Northhills Blvd, Fayetteville, AR 72703 Phone: 479-463-1000  | |
Mr. Charles Arthur Mccutchen Sr., C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 3873 N Parkview Dr, Fayetteville, AR 72703 Phone: 479-527-0050  | |
Victor Pribislavski, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 3394 N Futrall Dr, Fayetteville, AR 72703 Phone: 479-582-3360 Fax: 479-582-3466  | |
Heather Pribislavski, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3215 N Northhills Blvd, Fayetteville, AR 72703 Phone: 501-690-2708  | |
James Berry, C.R.N.A. Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 3318 N Northhills Blvd, Fayetteville, AR 72703 Phone: 479-872-1294  | |
Bradley Tow, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3215 N Northhills Blvd, Fayetteville, AR 72703 Phone: 770-643-5619  |