| Mr Sean Victor Pottenger, CRNA | |
|
1 Barnes Jewish Hospital Plz, Dept Anesthesiology, Saint Louis, MO 63110-1003 | |
| (800) 862-9980 | |
| (314) 362-1185 |
| Full Name | Mr Sean Victor Pottenger |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1 Barnes Jewish Hospital Plz, Saint Louis, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346813557 | NPI | - | NPPES |
| 910136728 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 2024004459 (Missouri) | Primary |
| Entity Name | Regents Of The Univ Of Ca |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013906973 PECOS PAC ID: 3375456619 Enrollment ID: O20031111000892 |
| Entity Name | County Of San Joaquin |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801830583 PECOS PAC ID: 6002703436 Enrollment ID: O20040301001287 |
| Entity Name | San Joaquin Faculty Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225063761 PECOS PAC ID: 4082631395 Enrollment ID: O20051026000742 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Sean Victor Pottenger, CRNA Po Box 60352, Saint Louis, MO 63160-0352 Ph: (800) 862-9980 | Mr Sean Victor Pottenger, CRNA 1 Barnes Jewish Hospital Plz, Dept Anesthesiology, Saint Louis, MO 63110-1003 Ph: (800) 862-9980 |
Ms. Mary Katherine Kinworthy, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 12634 Olive Blvd, Dept Anesthesiology, Saint Louis, MO 63141 Phone: 800-862-9980 Fax: 314-362-1185 | |
Ms. Kelsey Elise Fogus, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Barnes Jewish Hospital Plz, Dept Anesthesiology, Saint Louis, MO 63110 Phone: 800-862-9980 Fax: 314-362-1185 | |
Ms. Claira J Sousa, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Barnes Jewish Hospital Plz, Dept Anesthesiology, Saint Louis, MO 63110 Phone: 800-862-9980 Fax: 314-362-1185 | |
Claire Aubuchon, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 129 N Ballas Rd, Saint Louis, MO 63122 Phone: 314-996-5330 Fax: 314-810-1399 | |
Mr. Aaron M Weinzettel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Barnes Jewish Hospital Plz, Dept Anesthesiology, Saint Louis, MO 63110 Phone: 800-862-9980 Fax: 314-362-1185 | |
Ms. Tracy Lanes, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 915 N Grand Blvd, Saint Louis, MO 63106 Phone: 314-652-4100 | |
Mr. Michael Mccamley, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 12634 Olive Blvd, Saint Louis, MO 63141 Phone: 314-996-8685 Fax: 314-996-8479 |