| Ms Kellie L Deeter, CRNA | |
|
1171 Pioneer Pass, Norwalk, OH 44857-8928 | |
| (419) 706-4150 | |
| Not Available |
| Full Name | Ms Kellie L Deeter |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 6 Years |
| Location | 1171 Pioneer Pass, Norwalk, Ohio |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780870113 | NPI | - | NPPES |
| 2810980 | Medicaid | OH | |
| 481161444 | Other | OH | TAX ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LA2200X | Nurse Practitioner - Adult Health | LE-00027692 (Ohio) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 09618 (Ohio) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mercy Health - Willard Hospital | Willard, OH | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Firelands Anesthesia Associates Inc | 9032143334 | 7 |
| Entity Name | Firelands Anesthesia Associates Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811906340 PECOS PAC ID: 9032143334 Enrollment ID: O20050926001020 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Kellie L Deeter, CRNA 1171 Pioneer Pass, Norwalk, OH 44857-8928 Ph: (419) 706-4150 | Ms Kellie L Deeter, CRNA 1171 Pioneer Pass, Norwalk, OH 44857-8928 Ph: (419) 706-4150 |
Queen Ngwangong Mitti, DNP Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 272 Benedict Ave, Norwalk, OH 44857 Phone: 419-668-8101 | |
Mr. Michael J Brasko, C.R.N.A. Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1171 Pioneer Pass, Norwalk, OH 44857 Phone: 419-706-4150 | |
Scott Michael Elliott, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 272 Benedict Ave, Norwalk, OH 44857 Phone: 440-781-9318 |