Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLY BACON
ActiveKELLY BACON is a Certified Nurse Anesthetist (CRNA) healthcare provider located in IDABEL, Oklahoma. NPI 1700844313 is currently active in the NPPES registry. Verify at CMS.
Certified Nurse Anesthetist (CRNA) · IDABEL, OK
Registration Details
- NPI Number
- 1700844313
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 3, 2006 (20.299097624977 yrs)
- Last Updated
- Oct 26, 2021
- Licenses
-
R0071221 (OK)R0071221 (OK)
Practice Information
- Address
-
1301 E LINCOLN RDIDABEL, OK, 747457300Browse OK providers · Browse ZIP 74745
- Phone
- 5802867623
- Primary Specialty
-
Certified Nurse Anesthetist (CRNA)
367500000X
- Additional Specialty
- Certified Nurse Anesthetist (CRNA)
Other Certified Nurse Anesthetist (CRNA) Providers in IDABEL, OK
| Name | Credential | NPI |
|---|---|---|
| YESSENIA ISABELLE ZENTENO | — | 1285466425 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.