Larry John Lutz Jr., CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Eaton Rapids, MI
NPI 1023048121 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1023048121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 4704189964 (MI)
- Practice address
- 1500 S Main St
Eaton Rapids, MI 48827-1952 - Phone
- (517) 663-2671
- NPI assigned
- Jul 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110211000958 | MI | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 5698955359 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704189964 | MI | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eaton Rapids Medical Center | Current |
Accepting new patients | |
| Eaton Rapids Medical Center | Current |
Accepting new patients | |
| Henry Ford Health River District Hospital | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Locations
1500 S Main St
Eaton Rapids, MI 48827
Phone (517) 663-2671
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 4704189964 | MI | Yes |
Addresses
Primary practice location
1500 S Main St
Eaton Rapids, MI 48827-1952
Mailing address
7176 Crown Pointe Cir
Portage, MI 49024-4038
Phone (269) 321-8736
Other providers in Eaton Rapids, MI
- Laura Jo Launstein
- Lazaro Transitions MHT LLC
- William Robert Lindow
- Brenda F. Look
- Loving Hands Home Care Agency LLC
- M. Solarewicz Actt MHT LLC
- Kelly Maggart
- Maplewood Group Afc LLC
- Julia Anna Maraskine
- Roger Leo Merrill III
All providers in Eaton Rapids, MI · Certified Registered Nurse Anesthetist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.