Carla J Fowler, CRNA
Individual provider Active NPI Certified Registered Nurse Anesthetist · Sauk Centre, MN
NPI 1386912939 · NPPES record last updated Nov 8, 2024
Key facts
- NPI
- 1386912939
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Certified Registered Nurse Anesthetist 367500000X
- License
- 112 (MN)
- Practice address
- 10382 Augusta Dr
Sauk Centre, MN 56378-4864 - Phone
- (320) 351-8422
- NPI assigned
- Dec 11, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 18
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lakewood Health System
Practice addresses (Care Compare)
49725 County
Suite 83
Staples, MN 56479-5280
Phone (218) 894-1515
Hospital & facility affiliations
- Lakewood Health System
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120110000771 | MN | Practitioner - Certified Registered Nurse Anesthetist (Crna) | 5597931774 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112 | MN | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centracare Health System - Melrose | Current |
Accepting new patients | |
| Lakewood Health System | Current |
Accepting new patients | |
| Lakewood Health System | Current | Accepting new patients | |
| Centracare Health System - Melrose | Current |
Accepting new patients | |
| Lakewood Health System | Current |
Accepting new patients | |
| Lakewood Health System | Current |
Accepting new patients | |
| Lakewood Health System | Past | Accepting new patients |
Locations
525 Main St W
Melrose, MN 56352
Phone (320) 256-4228
200 W 1st St
Paynesville, MN 56362
Phone (320) 243-3767
1200 6th Ave N
Saint Cloud, MN 56303
Phone (320) 252-3342
1406 6th Ave N
Saint Cloud, MN 56303
Phone (320) 255-5657
49725 County 83
Staples, MN 56479
Phone (218) 894-1033
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R160100-0 | MN | |
| Certified Registered Nurse Anesthetist | 367500000X | 112 | MN | Yes |
Addresses
Primary practice location
10382 Augusta Dr
Sauk Centre, MN 56378-4864
Mailing address
460 River St W
Holdingford, MN 56340-4519
Phone (320) 248-2904
Other practice location 1
49725 County 83
Staples, MN 56479-5280
Phone (218) 894-1515
Other providers in Sauk Centre, MN
- Joel Ellis Dunn
- Eagle'S Healing Nest
- Mercedes Eke
- Fairway Pines
- Falls Court Dentists
- Brett Allen Freese
- Nicole Lynn Frie
- Trisha Kay Garvin
- Jenny Goelz
- Rachel Gruber
All providers in Sauk Centre, MN · Certified Registered Nurse Anesthetist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2024. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.