Provider Demographics
NPI:1043238405
Name:GASPER, STEVEN (CRNA)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:GASPER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9945 N 64TH AVE
Mailing Address - Street 2:
Mailing Address - City:MERRILL
Mailing Address - State:WI
Mailing Address - Zip Code:54452-7507
Mailing Address - Country:US
Mailing Address - Phone:715-675-4162
Mailing Address - Fax:
Practice Address - Street 1:601 S CENTER AVE
Practice Address - Street 2:
Practice Address - City:MERRILL
Practice Address - State:WI
Practice Address - Zip Code:54452-3404
Practice Address - Country:US
Practice Address - Phone:715-539-5136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI142133030367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI002721305OtherMEDICARE HUMANA GOLD
WI391330887OtherASSOCIATES FOR HEALTHCARE
WI80335OtherSECURITY HEALTH PLAN
WI80335OtherSECURITY HEALTH MEDICAID
WIGASPEROtherWPS
WI430075365OtherMEDICARE RAILROAD
WI391330887OtherHEALTH EOS
WI44315500OtherMANAGED HEALTH CARE
WI44315500Medicaid
WI44315500OtherMANAGED HEALTH CARE
WV002721305OtherSECURITY HEALTH ADVOCARE