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General NPI Number Information
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NPI Number | 1013535616
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Entity Type | Individual
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Provider Name | CALEB EARL KISER DNAP, CRNA
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Gender | Male
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Dates
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Enumeration Date | 07/09/2020
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 1425 PORTLAND AVE
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City | ROCHESTER
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State | NY
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Zip | 14621-3011
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Country | US
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Telephone | 585-922-4159
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Fax | 585-922-3731
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Provider Business Mailing Address
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Address Line | 611 SUNNYSIDE BLVD SE
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City | LAKE STEVENS
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State | WA
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Zip | 98258-3108
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Country | US
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Telephone | 402-612-8173
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 973706
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | AP61076820
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License Number State | WA
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