Provider Demographics
NPI:1619950110
Name:SEILER, GREGORY J (CRNA)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:J
Last Name:SEILER
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 1:200 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUSSELL
Mailing Address - State:KS
Mailing Address - Zip Code:67665-2920
Mailing Address - Country:US
Mailing Address - Phone:785-483-3131
Mailing Address - Fax:785-483-4859
Practice Address - Street 1:200 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RUSSELL
Practice Address - State:KS
Practice Address - Zip Code:67665-2920
Practice Address - Country:US
Practice Address - Phone:785-483-3131
Practice Address - Fax:785-483-4859
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS71879367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS145129OtherBCBS