Provider Demographics
NPI:1992939581
Name:REHA, CHRISTOPHER EDWARD (CRNA)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:EDWARD
Last Name:REHA
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 1:6911 VAN DORN ST
Mailing Address - Street 2:SUITE # 2
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-6801
Mailing Address - Country:US
Mailing Address - Phone:402-489-4186
Mailing Address - Fax:402-489-5279
Practice Address - Street 1:6911 VAN DORN ST
Practice Address - Street 2:SUITE # 2
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-6801
Practice Address - Country:US
Practice Address - Phone:402-489-4186
Practice Address - Fax:402-489-5279
Is Sole Proprietor?:No
Enumeration Date:2009-05-11
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE60065163W00000X
NE101090367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47061979815Medicaid
NE47061979815Medicaid