Healthcare Provider Details

I. General information

NPI: 1881197507
Provider Name (Legal Business Name): ANTONY K NGICU CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2018
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S 5TH ST STE A
SALINA KS
67401
US

IV. Provider business mailing address

PO BOX 1607
SALINA KS
67402-1607
US

V. Phone/Fax

Practice location:
  • Phone: 785-827-2238
  • Fax: 785-827-1684
Mailing address:
  • Phone: 785-827-2238
  • Fax: 785-827-1684

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number557610
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: