Provider Demographics
NPI:1104861533
Name:COVEY, SEAN NEIL (CRNA)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:NEIL
Last Name:COVEY
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 1:1299 BERTHA HOWE AVE
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:NV
Mailing Address - Zip Code:89027-7500
Mailing Address - Country:US
Mailing Address - Phone:702-345-4303
Mailing Address - Fax:702-345-4389
Practice Address - Street 1:1299 BERTHA HOWE AVE
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:NV
Practice Address - Zip Code:89027-7500
Practice Address - Country:US
Practice Address - Phone:702-345-4303
Practice Address - Fax:702-345-4389
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX727123367500000X
NVCRNA000337367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCRNA000337OtherLICENSE NUMBER
TX179319201Medicaid
TX148170101OtherFIRSTCARE COMERCIAL
TX86282UOtherHMO BLUE
TX86283UOtherBC/BS
TX148170100Medicaid
OK200078800AMedicaid
NM202005993OtherPRESBYTERIAN COMMERCIAL
NM202005993Medicaid
TX148170101OtherFIRSTCARE COMERCIAL
OK200078800AMedicaid