Kueckelhan, Gerald Lynn

Kueckelhan, Gerald Lynn is an individual health care provider with primary practice located at 2505 Mission Dr , Jefferson City MO 65109-9508. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Kueckelhan, Gerald Lynn can be contacted via phone (573) 636-3483.

Contact Information

Primary practice address
2505 Mission Dr Jefferson City MO 65109-9508
Phone: (573) 636-3483
Fax: (573) 636-3386
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 076407 Missouri

Profile Details

NPI number 1205822152
LBN Legal business name Kueckelhan, Gerald Lynn
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2005
Last updated Jan 26th, 2016 - about 9 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 1205822152 NPPES
Missouri Other 430050775 RR MEDICARE
Missouri MEDICAID 913912416 RR MEDICARE

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