Healthcare Provider Details
I. General information
NPI: 1699234211
Provider Name (Legal Business Name): KARYN KUDRNA APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/13/2019
Last Update Date: 03/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8 SALT CREEK LN
HINSDALE IL
60521-2903
US
IV. Provider business mailing address
411 ROBIN HILL DR
NAPERVILLE IL
60540-7324
US
V. Phone/Fax
- Phone: 331-221-2505
- Fax:
- Phone: 847-732-3568
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | 209019001 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: