Provider Demographics
NPI:1790702520
Name:MILBRODT, ARLIN J (CRNA)
Entity Type:Individual
Prefix:
First Name:ARLIN
Middle Name:J
Last Name:MILBRODT
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 1:379 SAGEBRUSH PASS
Mailing Address - Street 2:
Mailing Address - City:DAKOTA DUNES
Mailing Address - State:SD
Mailing Address - Zip Code:57049-5338
Mailing Address - Country:US
Mailing Address - Phone:605-232-3626
Mailing Address - Fax:
Practice Address - Street 1:600 N SIOUX POINT RD
Practice Address - Street 2:
Practice Address - City:DAKOTA DUNES
Practice Address - State:SD
Practice Address - Zip Code:57049-5000
Practice Address - Country:US
Practice Address - Phone:605-232-3332
Practice Address - Fax:605-232-0854
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCRNA0221367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD40756Medicare PIN