Healthcare Provider Details

I. General information

NPI: 1891105250
Provider Name (Legal Business Name): LINDSEY K KUDEJ BSN, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS LINDSEY K BOAL

II. Dates (important events)

Enumeration Date: 05/06/2014
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-384-7354
  • Fax:
Mailing address:
  • Phone: 319-356-2320
  • Fax: 319-384-6265

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberD118590
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: