Provider Demographics
NPI:1972596468
Name:FUERST, DUANE L (CRNA)
Entity type:Individual
Prefix:MR
First Name:DUANE
Middle Name:L
Last Name:FUERST
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 1:1017 MAXINE LN
Mailing Address - Street 2:SUITE 207
Mailing Address - City:VAN WERT
Mailing Address - State:OH
Mailing Address - Zip Code:45891-2649
Mailing Address - Country:US
Mailing Address - Phone:419-238-4139
Mailing Address - Fax:
Practice Address - Street 1:2793 SHAWNEE RD
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45806-1444
Practice Address - Country:US
Practice Address - Phone:419-227-8209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-30
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN147379163W00000X
OH33934367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH061649572-00OtherWORKMENS COMPENSATION
ND43007320OtherMEDICARE RAILROAD
OH000000249722OtherANTHEM BC/BS
OH0487638Medicaid
OH061649572002OtherMEDICAL MUTUAL OF OHIO
OH061649572002OtherMEDICAL MUTUAL OF OHIO