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NPI Code Detail

MEDICARE: JEFFREY D BARD CRNA

MEDICARE:   JEFFREY D BARD  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 AnesthetistR022430SD

Other Identifiers

General Provider Information

NPI Number : 1841285707
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY D BARD CRNA
Provider Business Mailing Address
First Line : PO BOX 5045
Second Line : ATTN: PROV ENROLL, P.F.S.
City : SIOUX FALLS
State : SD
Zip : 57117-5045
Country : US
Telephone Number : 605-322-2754
Fax Number : 605-322-2727
Provider Business Practice Location Address
First Line : 1325 S CLIFF AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57105-1007
Country : US
Telephone Number : 605-322-2754
Fax Number : 605-322-2727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2005
Last Update Date : 06/07/2011

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Directions to “ JEFFREY D BARD CRNA” Practice Location

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