| Mr John Thayer Edmondson, CRNA | |
|
2323 Texas St, Pecos, TX 79772-7338 | |
| (432) 447-3551 | |
| (432) 447-5434 |
| Full Name | Mr John Thayer Edmondson |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 2323 Texas St, Pecos, Texas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295799260 | NPI | - | NPPES |
| 023413 | Other | TN | CRNA CERTIFICATION NUMBER |
| 202890402 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | RN043542 (Tennessee) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | AP115284 (Texas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr John Thayer Edmondson, CRNA 2323 Texas St, Pecos, TX 79772-7338 Ph: (432) 447-3551 | Mr John Thayer Edmondson, CRNA 2323 Texas St, Pecos, TX 79772-7338 Ph: (432) 447-3551 |
Jerry F Giardina, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2323 Texas St, Pecos, TX 79772 Phone: 432-447-3551 Fax: 432-447-5434 |