Glen Deitrick, C.R.N.A
Certified Registered Nurse Anesthetist · Gulfport, MS
Glen Deitrick, C.R.N.A is a certified registered nurse anesthetist with a practice address in Gulfport, Mississippi, and NPI 1033214564, issued on Sep 13, 2006. Check the license (Mississippi R128610, as entered in NPPES) with the Mississippi board that licenses this profession; the federal record below is the public data PlainDoctor holds for this provider.
- Name
- Glen Deitrick
- Credential
- C.R.N.A
- Primary taxonomy
- Certified Registered Nurse Anesthetist 367500000X
- License number
- R128610 MS
Self-reported in NPPES; status is on the state search - Practice location
- 15190 Community RD, Gulfport, MS 39503
- Phone
- (228) 831-0204
- Enumerated
- Sep 13, 2006
- Record last updated
- Jul 8, 2007 (not updated in 19 years: call before relying on the address or phone)
- Fax
- (228) 831-1868
- Medicaid ID
- 00111157 MS
- Entity
- Type 1 · individual
8 nearest certified registered nurse anesthetist records → All 840 in Mississippi → Look up another NPI →
Also registered at 15190 Community RD
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Christina Barnes, CNPFamily Nurse Practitioner1427594480
- Victor Bazzone, MDSpecialist1972604650
- Michelle Bliss, CRNACertified Registered Nurse Anesthetist1811159460
- Clay Bratton, M.D.Specialist1952330417
- Joseph Cottone, M.D.Specialist1639177447
- Mimi Cumbest, D.O.Anesthesiology Physician1336254812
Verify Glen Deitrick in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Mississippi board licenses this profession
Search for license R128610Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Glen Deitrick among 840 certified registered nurse anesthetist records in Mississippi
Glen Deitrick, C.R.N.A is one of 840 certified registered nurse anesthetist records with a practice address in Mississippi. 84% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does not. Its NPI, issued in 2006, is newer than 3% of them.
- NPI issued2006 · 3% of these records are older, 63% newer
- In a Medicare fileNo · 84% of these records are
- In the CMS Doctors and Clinicians fileNo · 80% of these records are
- Record last updated2007 · 71% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 367500000X and a Mississippi practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
41 certified registered nurse anesthetist records list a practice address in Gulfport
They are 41 of the 2,030 NPPES records with a practice address in Gulfport, and 840 certified registered nurse anesthetist records in Mississippi. No Medicare prescribing, quality score, industry payment or hospital affiliation is published for this NPI.
All 840 in Mississippi → Every provider in Gulfport → Certified Registered Nurse Anesthetist nationwide →
The 8 certified registered nurse anesthetist records with the nearest ZIP codes
- Jeffrey Andre, CRNAGulfport, MS 395031619188604
- Michelle Bliss, CRNAGulfport, MS 395031811159460
- Glen Cavalier, CRNAGulfport, MS 395031043288541
- Stephanie Damitio, C.R.N.AGulfport, MS 395031447585435
- Kimberly Davis, CRNAGulfport, MS 395031184774473
- Peggy Ditta, C.R.N.A.Gulfport, MS 395031629173174
- Charles Giroir, C.R.N.AGulfport, MS 395031265537377
- Nancy Giroir, CRNAGulfport, MS 395031962552117
Common questions
What is Glen Deitrick, C.R.N.A's NPI number?
Glen Deitrick, C.R.N.A's National Provider Identifier (NPI) is 1033214564, issued on Sep 13, 2006. An NPI identifies a provider in billing; it is not a license.
Where is Glen Deitrick, C.R.N.A located?
The NPPES record lists a practice address at 15190 Community RD, Gulfport, MS, 39503. Phone: (228) 831-0204. Providers update this record themselves, so call before visiting.
How can I verify Glen Deitrick, C.R.N.A's license?
NPPES lists Mississippi license number R128610, as entered by the provider. Search the Mississippi board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.