Healthcare Provider Details

I. General information

NPI: 1174550347
Provider Name (Legal Business Name): RICHARD LOUIS KREIMAN CRNA, ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 09/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 MAIN STREET GUTTENBERG MUNICIPAL HOSPITAL
GUTTENBERG IA
52052-0550
US

IV. Provider business mailing address

279 GRAND RIDGE RIM WAY
GARNAVILLO IA
52049-8280
US

V. Phone/Fax

Practice location:
  • Phone: 563-252-1121
  • Fax:
Mailing address:
  • Phone: 563-422-8664
  • Fax: 563-252-1119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209000658
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberD071989
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2000146350
License Number StateMO
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number041275244
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2000146350
License Number StateMO
# 6
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberD071989
License Number StateIA
# 7
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number119429030
License Number StateWI
# 8
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN0000135791
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: