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General NPI Number Information
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NPI Number | 1184371619
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Entity Type | Individual
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Provider Name | KYLER MICHAEL PARKINSON CRNA
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Gender | Male
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Dates
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Enumeration Date | 03/04/2022
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 1229 C AVE E
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City | OSKALOOSA
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State | IA
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Zip | 52577-4246
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Country | US
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Telephone | 641-672-3388
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Fax |
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Provider Business Mailing Address
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Address Line | 1105 FOX RUN DR
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City | OSKALOOSA
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State | IA
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Zip | 52577-4164
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Country | US
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Telephone | 208-709-6248
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | D169373
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License Number State | IA
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