Provider Demographics
NPI:1437127511
Name:CATRON, RICHARD J (CRNA)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:J
Last Name:CATRON
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 1:4258 ARIZONA AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-1005
Mailing Address - Country:US
Mailing Address - Phone:308-382-2663
Mailing Address - Fax:
Practice Address - Street 1:4258 ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-1005
Practice Address - Country:US
Practice Address - Phone:308-382-2663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE100353367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025009800Medicaid
NE10025009800Medicaid
NE279679Medicare ID - Type Unspecified