| Mr Glenn Ray White, CRNA | |
|
112 Jefferson St, West Union, IA 52175-1022 | |
| (563) 422-3811 | |
| Not Available |
| Full Name | Mr Glenn Ray White |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 15 Years |
| Location | 112 Jefferson St, West Union, Iowa |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497058259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 2011002332 (Missouri) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | D130493 (Iowa) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Gastrointestinal Associates S.c. | 4385677814 | 45 |
| Entity Name | St Clare Memorial Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1851477913 PECOS PAC ID: 0446211395 Enrollment ID: O20041023000037 |
| Entity Name | Aspirus Stevens Point Hospital & Clinics, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538112230 PECOS PAC ID: 1850358938 Enrollment ID: O20041210000558 |
| Entity Name | Gastrointestinal Associates S.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760546949 PECOS PAC ID: 4385677814 Enrollment ID: O20050915000417 |
| Entity Name | Midwest Alliance Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1336612795 PECOS PAC ID: 9234477092 Enrollment ID: O20190221000168 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Glenn Ray White, CRNA Po Box 7687, Columbia, MO 65205-7687 Ph: (573) 882-2259 | Mr Glenn Ray White, CRNA 112 Jefferson St, West Union, IA 52175-1022 Ph: (563) 422-3811 |
Mr. Richard Yngve Jacobson Jr., CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 112 Jefferson St, West Union, IA 52175 Phone: 563-422-3811 | |
Barry Spreen, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 112 Jefferson St, West Union, IA 52175 Phone: 319-422-3811 | |
Nikki A. Bonitz, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 112 Jefferson St, West Union, IA 52175 Phone: 563-422-7381 | |
Kenneth Bryan Beach, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 112 Jefferson St, West Union, IA 52175 Phone: 563-422-9738 |