NPI: 1487020111 · MARYVILLE, IL 62062 · Certified Registered Nurse Anesthetist · NPI assigned 08/17/2015
| Authorized Official | PRUETZEL, RANDY (MANAGER) |
| NPI Enumeration Date | 08/17/2015 |
| Year | Claims | Total Paid |
|---|---|---|
| 2023 | 13 | $1K |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 01992 | 13 | 12 | $1K |