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General NPI Number Information
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NPI Number | 1043238405
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Entity Type | Individual
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Provider Name | STEVEN GASPER CRNA
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 11/17/2022
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Provider Practice Location Address
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Address Line | 601 S CENTER AVE
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City | MERRILL
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State | WI
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Zip | 54452-3404
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Country | US
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Telephone | 715-539-5136
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Fax |
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Provider Business Mailing Address
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Address Line | 9945 N 64TH AVE
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City | MERRILL
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State | WI
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Zip | 54452-7507
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Country | US
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Telephone | 715-675-4162
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 142133030
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License Number State | WI
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