MEDICARE: KENT A OUSLEY CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	1055066	KY
2	163W00000X	Registered Nurse	RN.198180	OH
3	163W00000X	Registered Nurse	28209070A	IN
4	367500000X	Certified Registered Nurse Anesthetist	44587	KY
5	367500000X	Certified Registered Nurse Anesthetist	COA.00299-NA	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	27150036	OTHER	HEALTHNET
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000288574	OTHER	ANTHEM BLUE SHIELD
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255315040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENT A OUSLEY CRNA

Provider Business Mailing Address
First Line	:	200 NORTHLAND BLVD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45246
Country	:	US
Telephone Number	:	513-215-1488
Fax Number	:	513-215-1978

Provider Business Practice Location Address
First Line	:	3300 MERCY HEALTH BLVD
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-1103
Country	:	US
Telephone Number	:	513-215-1488
Fax Number	:	513-215-1978

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	07/09/2015

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Directions to “ KENT A OUSLEY CRNA” Practice Location

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