Healthcare Provider Details

I. General information

NPI: 1932178506
Provider Name (Legal Business Name): LOUANN FISHER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 02/10/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1823 COLLEGE AVE
MANHATTAN KS
66502
US

IV. Provider business mailing address

1310A WESTLOOP PL # 196
MANHATTAN KS
66502-2842
US

V. Phone/Fax

Practice location:
  • Phone: 785-477-2700
  • Fax:
Mailing address:
  • Phone: 785-477-2700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number54661
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: