Healthcare Provider Details

I. General information

NPI: 1396311353
Provider Name (Legal Business Name): SRI HARSHA KANURI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2021
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W 24TH ST
KEARNEY NE
68847-5358
US

IV. Provider business mailing address

101 W 24TH ST
KEARNEY NE
68847-5358
US

V. Phone/Fax

Practice location:
  • Phone: 308-251-5035
  • Fax:
Mailing address:
  • Phone: 308-251-5035
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number37427
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: