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NPI Code Detail

MEDICARE: GEORGE D KENDALL CRNA, MSN

MEDICARE:   GEORGE D KENDALL  CRNA, MSN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse AnesthetistRN-240448OH
2367500000XCertified Registered Nurse Anesthetist28200961IN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
128200961OTHERINRN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881687705
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE D KENDALL CRNA, MSN
Provider Business Mailing Address
First Line : PO BOX 12
Second Line :
City : BEDFORD
State : IN
Zip : 47421-3510
Country : US
Telephone Number : 740-380-8068
Fax Number : 740-380-8152
Provider Business Practice Location Address
First Line : 2900 W 16TH STREET
Second Line :
City : BEDFORD
State : IN
Zip : 47421-3510
Country : US
Telephone Number : 812-275-1200
Fax Number : 812-275-1212
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2005
Last Update Date : 08/28/2012

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Directions to “ GEORGE D KENDALL CRNA, MSN” Practice Location

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