Healthcare Provider Details

I. General information

NPI: 1134790082
Provider Name (Legal Business Name): KIMY JOAN MIRA DNAP, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 03/03/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8072 N MILLBROOK AVE APT 263
FRESNO CA
93720-2295
US

IV. Provider business mailing address

8072 N MILLBROOK AVE APT 263
FRESNO CA
93720-2295
US

V. Phone/Fax

Practice location:
  • Phone: 408-807-7247
  • Fax:
Mailing address:
  • Phone: 408-807-7247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number147576
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number95085159
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: