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1962476739

NPI Code Detail

MEDICARE: KEVIN M RHODUS CRNA

MEDICARE: KEVIN M RHODUS 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	C-APN.0000892-C-CRNA	CO
2	367500000X	Certified Registered Nurse Anesthetist	R54743	NM

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	P00329269	OTHER	NM	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10020355	OTHER	NM	LOVELACE HP
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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	202000353	OTHER	NM	PRESBYTERIAN HP
6	NM006B15	OTHER	NM	BCBS
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962476739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN M RHODUS CRNA

Provider Business Mailing Address
First Line	:	6 WAPITI LOOP
Second Line	:
City	:	TAOS
State	:	NM
Zip	:	87571-7124
Country	:	US
Telephone Number	:	505-947-6660
Fax Number	:

Provider Business Practice Location Address
First Line	:	1397 WEIMER RD
Second Line	:
City	:	TAOS
State	:	NM
Zip	:	87571-6253
Country	:	US
Telephone Number	:	575-758-8883
Fax Number	:

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

Provider Enumeration Date	:	02/16/2006
Last Update Date	:	03/05/2018

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Directions to “ KEVIN M RHODUS CRNA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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