Provider Demographics
NPI:1952336356
Name:WOODEN, STEVEN (CRNA MS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:WOODEN
Suffix:
Gender:M
Credentials:CRNA MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 S 8TH ST
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:NE
Mailing Address - Zip Code:68620-1324
Mailing Address - Country:US
Mailing Address - Phone:402-395-6333
Mailing Address - Fax:
Practice Address - Street 1:723 W FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NE
Practice Address - Zip Code:68620-1725
Practice Address - Country:US
Practice Address - Phone:402-395-6333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE100313367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE38002OtherBLUE CROSS BLUE SHIELD
NE272130Medicare PIN