Provider Demographics
NPI:1780691451
Name:ANDERSON, BYRON K (CRNA)
Entity type:Individual
Prefix:MR
First Name:BYRON
Middle Name:K
Last Name:ANDERSON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 151
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:NE
Mailing Address - Zip Code:68620-0151
Mailing Address - Country:US
Mailing Address - Phone:402-395-3213
Mailing Address - Fax:402-395-3173
Practice Address - Street 1:723 WEST FAIRVIEW
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NE
Practice Address - Zip Code:68620
Practice Address - Country:US
Practice Address - Phone:402-395-2191
Practice Address - Fax:402-395-5165
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE19895163W00000X
NE100001367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered