Provider Demographics
NPI:1669566758
Name:LIHS, JASON TROY (CRNA)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:TROY
Last Name:LIHS
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:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:CLARINDA
Mailing Address - State:IA
Mailing Address - Zip Code:51632-2625
Mailing Address - Country:US
Mailing Address - Phone:712-542-2186
Mailing Address - Fax:712-542-8311
Practice Address - Street 1:220 ESSIE DAVISON DR
Practice Address - Street 2:
Practice Address - City:CLARINDA
Practice Address - State:IA
Practice Address - Zip Code:51632-2915
Practice Address - Country:US
Practice Address - Phone:712-542-2176
Practice Address - Fax:712-542-8297
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA102258367500000X
IAD102258367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA102258OtherSTATE CRNA LICENSE
IA102258OtherSTATE CRNA LICENSE