| Traci Renee Wilmarth, CRNA | |
|
9713 Lakecrest Dr, Oklahoma City, OK 73159-6777 | |
| (405) 213-5351 | |
| Not Available |
| Full Name | Traci Renee Wilmarth |
|---|---|
| Gender | Female |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 12 Years |
| Location | 9713 Lakecrest Dr, Oklahoma City, Oklahoma |
| 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 |
|---|---|---|---|
| 1003245481 | NPI | - | NPPES |
| 1003245481 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 100545 (Oklahoma) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southern Plains Medical Center Inc | 5991618969 | 11 |
| Entity Name | Southern Plains Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962469098 PECOS PAC ID: 5991618969 Enrollment ID: O20031106000698 |
| Entity Name | Digestive Disease Specialists Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366489213 PECOS PAC ID: 7315939279 Enrollment ID: O20040331001151 |
| Mailing Address | Practice Location Address |
|---|---|
| Traci Renee Wilmarth, CRNA 9713 Lakecrest Dr, Oklahoma City, OK 73159-6777 Ph: (405) 213-5351 | Traci Renee Wilmarth, CRNA 9713 Lakecrest Dr, Oklahoma City, OK 73159-6777 Ph: (405) 213-5351 |
Paul Jason Bradley, RN Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 920 Stanton L Young Blvd # Wp1140, Oklahoma City, OK 73104 Phone: 405-271-4351 Fax: 405-271-8695 | |
Michael Sean O'dell, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 5501 N Portland Ave, Oklahoma City, OK 73112 Phone: 405-604-6000 | |
Mr. Darryl W. Jones, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 100 Ne 85th St, Oklahoma City, OK 73114 Phone: 405-631-3085 Fax: 405-616-2679 | |
Ivan Kozhulenko, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 920 Stanton L Young Blvd Ste Wp1140, Oklahoma City, OK 73104 Phone: 405-271-4351 Fax: 405-271-8695 | |
Jasilin Hall, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 5501 N Portland Ave, Oklahoma City, OK 73112 Phone: 405-604-6000 | |
Robert Lee Rawls, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 9600 Broadway Ext, Oklahoma City, OK 73114 Phone: 405-715-3610 Fax: 405-715-3612 |