Provider Demographics
NPI:1386792901
Name:MESSER, EDWARD DEAN (CRNA)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:DEAN
Last Name:MESSER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 DR RUSSELL SMITH WAY
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-7402
Mailing Address - Country:US
Mailing Address - Phone:417-359-2653
Mailing Address - Fax:417-358-4612
Practice Address - Street 1:3125 DR RUSSELL SMITH WAY
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-7402
Practice Address - Country:US
Practice Address - Phone:417-359-2653
Practice Address - Fax:417-358-4612
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO129099367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO773640OtherHEALTHLINK
MOP01163146OtherRAIL ROAD MEDICARE
MOP01163146OtherRAIL ROAD MEDICARE
MOMA3832014Medicare PIN