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NPI Code Detail

MEDICARE: BRENT THOMAS KAPFER CRNA

MEDICARE: BRENT THOMAS KAPFER 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
1367500000XCertified Registered Nurse AnesthetistR1350160MN
2367500000XCertified Registered Nurse Anesthetist4255WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1096H0KAOTHERMNBLUE CROSS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467418368
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENT THOMAS KAPFER CRNA
Provider Business Mailing Address
First Line : 10513 STONEBRIDGE TRL N
Second Line :
City : STILLWATER
State : MN
Zip : 55082-9569
Country : US
Telephone Number : 612-382-4613
Fax Number :
Provider Business Practice Location Address
First Line : 257 W SAINT GEORGE AVE
Second Line :
City : GRANTSBURG
State : WI
Zip : 54840-7827
Country : US
Telephone Number : 715-463-7239
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2006
Last Update Date : 01/26/2022

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Directions to “ BRENT THOMAS KAPFER CRNA” Practice Location

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