| Kellie Logue, CRNA | |
|
214 S 4th St, Kremmling, CO 80459-5065 | |
| (970) 887-5800 | |
| Not Available |
| Full Name | Kellie Logue |
|---|---|
| Gender | Female |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 214 S 4th St, Kremmling, Colorado |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275940496 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 185347 (Tennessee) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | APN.0993708-CRNA (Colorado) | Primary |
| Entity Name | Kremmling Memorial Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619962321 PECOS PAC ID: 7517871544 Enrollment ID: O20040312001110 |
| Entity Name | South Denver Gastroenterology, P.c |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447364831 PECOS PAC ID: 2062302508 Enrollment ID: O20040317001558 |
| Entity Name | Southern Colorado Crna Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043538382 PECOS PAC ID: 3072785559 Enrollment ID: O20111005000146 |
| Entity Name | Arapahoe Gastroenterology Anesthesia Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598115479 PECOS PAC ID: 2466745294 Enrollment ID: O20160801001103 |
| Entity Name | Arkansas Valley Regional Medical Center |
|---|---|
| Entity Type | Part B Supplier - Hospital Department(s) |
| Entity Identifiers | NPI Number: 1609320514 PECOS PAC ID: 9436062833 Enrollment ID: O20180205002945 |
| Entity Name | 444 Wellness Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619600285 PECOS PAC ID: 6204211998 Enrollment ID: O20220915003690 |
| Entity Name | North Denver Anesthesia Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902624422 PECOS PAC ID: 9234667346 Enrollment ID: O20250116001345 |
| Mailing Address | Practice Location Address |
|---|---|
| Kellie Logue, CRNA Po Box 399, Kremmling, CO 80459-0399 Ph: (309) 202-1692 | Kellie Logue, CRNA 214 S 4th St, Kremmling, CO 80459-5065 Ph: (970) 887-5800 |