Healthcare Provider Details

I. General information

NPI: 1639815277
Provider Name (Legal Business Name): LELAND D MURREN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2022
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 N SAINT JOSEPH AVE
HASTINGS NE
68901-4497
US

IV. Provider business mailing address

715 N SAINT JOSEPH AVE
HASTINGS NE
68901-4497
US

V. Phone/Fax

Practice location:
  • Phone: 402-463-4521
  • Fax:
Mailing address:
  • Phone: 402-463-4521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number296446
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR047301
License Number StateSD
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number276446
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: