Etheridge, Daniel

Etheridge, Daniel is an individual health care provider with primary practice located at 250 Park St , Bowling Green KY 42101-1760. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Etheridge, Daniel can be contacted via phone (270) 393-1912.

Contact Information

Primary practice address
250 Park St Bowling Green KY 42101-1760
Phone: (270) 393-1912
Fax: (270) 393-1913
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 155950 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 3008449 Kentucky

Profile Details

NPI number 1043649809
LBN Legal business name Etheridge, Daniel
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2013
Last updated Jan 27th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043649809 NPPES
Kentucky MEDICAID 7100275390

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