Nicholas Becker, CRNA

Individual provider Active NPI Certified Registered Nurse Anesthetist · Galesburg, IL

NPI 1043769987 · NPPES record last updated Oct 3, 2016

Key facts

NPI
1043769987
Entity type
Individual (NPI type 1)
Primary specialty
Certified Registered Nurse Anesthetist 367500000X
License
209014828 (IL)
Practice address
3333 N Seminary St
Galesburg, IL 61401-1251
Phone
(309) 344-3161
Fax
(309) 344-9498
NPI assigned
Oct 3, 2016
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 209014828 IL Yes

Addresses

Primary practice location

3333 N Seminary St
Galesburg, IL 61401-1251

Mailing address

3333 N Seminary St
Galesburg, IL 61401-1251
Phone (309) 344-3161

Other providers in Galesburg, IL

All providers in Galesburg, IL · Certified Registered Nurse Anesthetist in Illinois

Sources for this page

Verify at the official NPI Registry.