Provider Demographics
NPI:1134232317
Name:STRAHM, KEVIN RAY (CRNA MS)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:RAY
Last Name:STRAHM
Suffix:
Gender:M
Credentials:CRNA MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 MERCY RD
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2372
Mailing Address - Country:US
Mailing Address - Phone:402-398-6176
Mailing Address - Fax:402-398-5576
Practice Address - Street 1:7710 MERCY RD STE 424
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2346
Practice Address - Country:US
Practice Address - Phone:402-398-6176
Practice Address - Fax:402-398-6176
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE100756367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE277097OtherCOVENTRY
NE35936OtherMIDLANDS
NE430079157OtherRAILROAD
NE279960Medicare ID - Type UnspecifiedCCH MEDICARE PROV #
NE430079157OtherRAILROAD