MEDICARE: NORA L BENTLEY CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	RN-196070	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	34-0891295	OTHER	OH	EMPLOYER FEDERAL TAX ID #
2	730617	OTHER	OH	BUCKEYE COMMUNITY HLTH PL
3	120805	OTHER	OH	KAISER PERMANENTE INDV #
4	000000125743	OTHER	OH	ANTHEM BCBS INDV NUMBER
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	100153	OTHER	OH	EMPLOYER KAISER GROUP #
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	2080224	OTHER	OH	EMP UNITED HEALTHCARE GRP

General Provider Information

NPI Number	:	1508816067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORA L BENTLEY CRNA

Provider Business Mailing Address
First Line	:	2215 E WATERLOO RD STE 313
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44312-3856
Country	:	US
Telephone Number	:	330-208-2720
Fax Number	:	330-208-2721

Provider Business Practice Location Address
First Line	:	3780 MEDINA RD STE 120
Second Line	:
City	:	MEDINA
State	:	OH
Zip	:	44256-9312
Country	:	US
Telephone Number	:	330-208-2720
Fax Number	:	330-208-2721

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	11/19/2018

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Directions to “ NORA L BENTLEY CRNA” Practice Location

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