Healthcare Provider Details

I. General information

NPI: 1255019253
Provider Name (Legal Business Name): COREYNE LYNNE KURJATKO CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2023
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 N GRANDVIEW AVE
DUBUQUE IA
52001-6388
US

IV. Provider business mailing address

260 HAWKEYE CT APT 108
IOWA CITY IA
52246-2865
US

V. Phone/Fax

Practice location:
  • Phone: 563-582-1881
  • Fax:
Mailing address:
  • Phone: 507-513-1481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberD175182
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: