Shelley Kay Foutch, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Omaha, NE
NPI 1083722508 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1083722508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 100637 (NE)
- Practice address
- 6901 N 72 Street
Omaha, NE 68122 - Phone
- (402) 572-2160
- Fax
- (402) 334-2849
- NPI assigned
- Aug 25, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D101829 | IA | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic Anesthesia Specialists, LLC | Past | Accepting new patients | |
| Professional Anesthesia Services LLP | Past | Accepting new patients | |
| Diagnostic & Int Med Assoc PC | Past | Accepting new patients | |
| Anesthesia West, P.C. | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Memorial Community Hospital Corporation | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 100637 | NE | Yes |
| Certified Registered Nurse Anesthetist | 367500000X | D101829 | IA |
Addresses
Primary practice location
6901 N 72 Street
Omaha, NE 68122
Mailing address
PO Box 34310
Omaha, NE 68134
Phone (402) 778-9737
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 470550438-15 | Medicaid | NE | |
| 0520395 | Medicaid | IA |
Other names
- Shelley Kay Richardson
Other providers in Omaha, NE
- Rolene Latosha Fountain
- Fountainhead Counseling LLC
- Afaf M Fourawi
- Jutta L Fournier
- Emily Kay Foutch
- Amanda Fouts
- Dena Fouts
- Samiksha Fouzdar Jain
- Andreana Fowler
- Bobbie Jean Fowler
All providers in Omaha, NE · Certified Registered Nurse Anesthetist in Nebraska
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.