| Savannah A Clark, CRNA | |
|
100 Hospital Dr, Lebanon, MO 65536-9210 | |
| (417) 533-6100 | |
| Not Available |
| Full Name | Savannah A Clark |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 13 Years |
| Location | 100 Hospital Dr, Lebanon, Missouri |
| 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 |
|---|---|---|---|
| 1992147615 | NPI | - | NPPES |
| 431560263 | Other | MO | TRICARE |
| P01235238 | Other | MO | RR MCR |
| 1992147615 | Medicaid | MO | |
| 199441001 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 2013026436 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Citizens Memorial Hospital | Bolivar, MO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Citizens Memorial Hospital District | 2769574433 | 33 |
| Entity Name | Citizens Memorial Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558548818 PECOS PAC ID: 2769574433 Enrollment ID: O20070827000044 |
| Entity Name | Guardian Anesthesia Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215366307 PECOS PAC ID: 6608005111 Enrollment ID: O20140203001776 |
| Mailing Address | Practice Location Address |
|---|---|
| Savannah A Clark, CRNA 100 Hospital Dr, Lebanon, MO 65536-9210 Ph: (417) 533-6100 | Savannah A Clark, CRNA 100 Hospital Dr, Lebanon, MO 65536-9210 Ph: (417) 533-6100 |
Debra A Hoerth, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 120 Hospital Dr, Lebanon, MO 65536 Phone: 417-533-6100 | |
David Houzenga, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 120 Hospital Dr, Lebanon, MO 65536 Phone: 417-533-6100 | |
Sara L Kruse, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 100 Hospital Dr, Lebanon, MO 65536 Phone: 417-533-6026 | |
Susan Love, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 100 Hospital Dr, Lebanon, MO 65536 Phone: 417-533-6100 | |
Mr. Nathan S Larson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 100 Hospital Dr, Lebanon, MO 65536 Phone: 417-533-6100 Fax: 417-533-6021 | |
Janice A Shore, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 100 Hospital Dr, Lebanon, MO 65536 Phone: 800-277-8151 Fax: 336-841-6217 | |
Desiree Calbert, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 100 Hospital Dr, Lebanon, MO 65536 Phone: 417-533-6100 |