Person

Kelly R Etzel

Debarred entity

Born 19 Apr 1961 (65 years old),United States. Named in 4 sanctions listings.

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Sanctions and listings4

  • Listed
    25 Apr 2017
    Effective
    20 Apr 2017

    Reciprocal

    HHSUS SAM Procurement ExclusionsUnited StatesActive

    Prohibition/Restriction

    Excluded by the Department of Health and Human Services pursuant to section 1128 or other sections of the Social Security Act from participation in all Federal health care programs (the scope and effect of Federal health care program exclusions is described in 42 C.F.R. section 1001.1901).

    sam.gov

  • Effective
    20 Apr 2017

    List of Excluded Individuals/Entities (LEIE)

    Department of Health and Human Services Office of Inspector GeneralUS Health and Human Services Inspector General ExclusionsUnited States

    1128a4

    Programme US-HHS-OIGoig.hhs.govoig.hhs.gov

  • Effective
    20 Apr 2017

    Official designation

    Montana Department of Public Health & Human ServicesUS Montana Medicaid Excluded and Terminated ProvidersUnited States

    dphhs.mt.gov

  • Listed
    22 Aug 2017
    Effective
    29 Jun 2017

    Reciprocal

    OPMUS SAM Procurement ExclusionsUnited StatesActive

    Prohibition/Restriction

    sam.gov

Positions held1

  1. Period not retained

    PHYSICIAN ASSISTANT (IND- LIC HC SERV PRO)

Identifiers1

IdentifierNumber
NPI number1639285281

Addresses2

  • LOLO, MT 59847

  • 5804 LEGEND LANE, LOLO, MT 59847

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