Healthcare Provider Details

I. General information

NPI: 1730118183
Provider Name (Legal Business Name): JAMES M MESCHER CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 02/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6901 N 72ND ST
OMAHA NE
68122-1709
US

IV. Provider business mailing address

PO BOX 34310
OMAHA NE
68134-0310
US

V. Phone/Fax

Practice location:
  • Phone: 402-778-9738
  • Fax: 402-334-2849
Mailing address:
  • Phone: 402-778-9738
  • Fax: 402-334-2849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number100945
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberD105097
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: