| Laurie A Harris, CRNA | |
| 
					1235 E Cherokee St, Springfield, MO 65804-2203  | |
| (417) 820-2829 | |
| (417) 820-8852 | 
| Full Name | Laurie A Harris | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Anesthetist, Certified Registered | 
| Location | 1235 E Cherokee St, Springfield, Missouri | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1275671620 | NPI | - | NPPES | 
| 917229106 | Medicaid | MO | |
| 159250001 | Medicaid | AR | |
| 175118 | Other | MO | MO BLUE SHIELD | 
| 83413 | Other | AR | ARK BLUE SHIELD | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | ARNP9427379 (Florida) | Secondary | 
| 367500000X | Nurse Anesthetist, Certified Registered | 123514 (Missouri) | Primary | 
| Entity Name | Four States Anesthesia Services Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1053382929 PECOS PAC ID: 8729973284 Enrollment ID: O20040216000537  | 
| Entity Name | Ambulatory Anesthesia Services Of St. Charles, Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1467634097 PECOS PAC ID: 3173604782 Enrollment ID: O20080121000079  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Laurie A Harris, CRNA Po Box 2580, Springfield, MO 65801-2580 Ph: (417) 829-4620  | Laurie A Harris, CRNA 1235 E Cherokee St, Springfield, MO 65804-2203 Ph: (417) 820-2829  | 
Olivia M. Kilburn, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2829 Fax: 417-820-8852  | |
Mr. David E Meinhardt, C.R.N.A. Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1265 E Primrose St, Springfield, MO 65804 Phone: 417-886-3937 Fax: 417-886-1285  | |
Jacquelyn B Marshall, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2829  | |
Dione E Blansit, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2829  | |
Jesse D Collins, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2829 Fax: 417-820-8852  | |
Bradley A Korman, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2829 Fax: 417-820-8852  | |
John D Ford, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1235 E Cherokee St, Springfield, MO 65804 Phone: 417-820-2829 Fax: 417-820-8852  |