Provider Demographics
NPI:1801027479
Name:GROSSHANS, JAMES ALLEN (CRNA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ALLEN
Last Name:GROSSHANS
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 1:645 OSAGE
Mailing Address - Street 2:MEMORIAL HEALTH CENTER
Mailing Address - City:SIDNEY
Mailing Address - State:NE
Mailing Address - Zip Code:69162
Mailing Address - Country:US
Mailing Address - Phone:308-254-5825
Mailing Address - Fax:308-254-8095
Practice Address - Street 1:645 OSAGE
Practice Address - Street 2:MEMORIAL HEALTH CENTER
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162
Practice Address - Country:US
Practice Address - Phone:308-254-5825
Practice Address - Fax:308-254-8095
Is Sole Proprietor?:No
Enumeration Date:2009-07-30
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE100326367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered