Bison, Jeremy Shane

Bison, Jeremy Shane is an individual health care provider with primary practice located at 2430 W Pierce St , Carlsbad NM 88220-3553. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Bison, Jeremy Shane can be contacted via phone (318) 934-2242.

Contact Information

Primary practice address
2430 W Pierce St Carlsbad NM 88220-3553
Phone: (318) 934-2242
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X CRNA-01281 New Mexico

Profile Details

NPI number 1194079806
LBN Legal business name Bison, Jeremy Shane
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2012
Last updated Jul 1st, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194079806 NPPES
New Mexico MEDICAID 78584051

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