Boren, Richard Earl

Boren, Richard Earl is an sole proprietor health care provider with primary practice located at 2 S Hospital Dr , Murphysboro IL 62966-3333. 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. Boren, Richard Earl can be contacted via phone (618) 684-3156.

Contact Information

Primary practice address
2 S Hospital Dr Murphysboro IL 62966-3333
Phone: (618) 684-3156
Fax: (618) 529-0529
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 209-005603 Illinois

Profile Details

NPI number 1346353117
LBN Legal business name Boren, Richard Earl
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 16th, 2006
Last updated Sep 13th, 2021 - about 5 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 1346353117 NPPES
Illinois Other 214881 MEDICARE MULTISPECIALTY GROUP PTAN

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