Provider Demographics
NPI:1497844922
Name:MOHR, RUFUS EDWIN (CRNA)
Entity Type:Individual
Prefix:
First Name:RUFUS
Middle Name:EDWIN
Last Name:MOHR
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 1:129 FAIRWAY LN
Mailing Address - Street 2:
Mailing Address - City:FORT MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701-9219
Mailing Address - Country:US
Mailing Address - Phone:970-867-0978
Mailing Address - Fax:970-867-0996
Practice Address - Street 1:118 EAST HASKELL ST
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445-3247
Practice Address - Country:US
Practice Address - Phone:775-623-5222
Practice Address - Fax:775-625-8590
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2010-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVCRNA000298367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered