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1639164742

NPI Code Detail

MEDICARE: SHERILYN R WETER CRNA

MEDICARE: SHERILYN R WETER 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	029375	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	739499	OTHER	MO	HEALTHLINK
5	P00202167	OTHER	MO	RAILROAD
6	18866	OTHER	MO	COX HEALTH
7	194111	OTHER	MO	BCBS
8	20174319965616B004	OTHER	MO	TRICARE

General Provider Information

NPI Number	:	1639164742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERILYN R WETER CRNA

Provider Business Mailing Address
First Line	:	PO BOX 1308
Second Line	:
City	:	BRANSON
State	:	MO
Zip	:	65615
Country	:	US
Telephone Number	:	417-239-3392
Fax Number	:	417-239-3394

Provider Business Practice Location Address
First Line	:	251 SKAGGS RD
Second Line	:
City	:	BRANSON
State	:	MO
Zip	:	65616-2031
Country	:	US
Telephone Number	:	800-277-8151
Fax Number	:

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	05/21/2009

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Directions to “ SHERILYN R WETER CRNA” Practice Location

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