Provider Demographics
NPI:1699793653
Name:EIKANGER, JEFFREY L (CRNA)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:L
Last Name:EIKANGER
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:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-333-1000
Mailing Address - Fax:
Practice Address - Street 1:1305 W 18TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-0401
Practice Address - Country:US
Practice Address - Phone:605-333-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI148812030367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI391330887OtherHEALTH EOS
WI44332200OtherMANAGED HEALTH CARE
WI44332200Medicaid
WI391330887OtherASSOCIATES FOR HEALTHCARE
WIEIKANGEROtherWPS
WI93215OtherSECURITY HEALTH MEDICAID
WIP00151116OtherMEDICARE RAILROAD
WI93215OtherSECURITY HEALTH PLAN
WI004421305OtherMEDICARE HUMANA GOLD
WI391330887OtherASSOCIATES FOR HEALTHCARE
WI93215OtherSECURITY HEALTH MEDICAID