Provider Demographics
NPI:1184697591
Name:FORBUSH, CURTIS RAY (CRNA)
Entity type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:RAY
Last Name:FORBUSH
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 1:1500 AVENUE H
Mailing Address - Street 2:
Mailing Address - City:ELY
Mailing Address - State:NV
Mailing Address - Zip Code:89301-2615
Mailing Address - Country:US
Mailing Address - Phone:775-289-3467
Mailing Address - Fax:775-289-8244
Practice Address - Street 1:1500 AVENUE H
Practice Address - Street 2:
Practice Address - City:ELY
Practice Address - State:NV
Practice Address - Zip Code:89301-2615
Practice Address - Country:US
Practice Address - Phone:775-289-3467
Practice Address - Fax:775-289-8244
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNVRN31575163W00000X
NVNVCRNA000152367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVS31695Medicare UPIN
NVV34420Medicare ID - Type UnspecifiedMEDICARE PART B PROV. #