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General NPI Number Information
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NPI Number | 1205886553
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Entity Type | Individual
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Provider Name | MARK J KRIDLER CRNA
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Gender | Male
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 516 PELLIS RD 2020 SURGERY CENTER
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City | GREENSBURG
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State | PA
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Zip | 15601-4506
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Country | US
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Telephone | 724-836-1177
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Fax | 724-836-4700
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Provider Business Mailing Address
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Address Line | 121 KILBUCK DR
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City | MONROEVILLE
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State | PA
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Zip | 15146-4905
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Country | US
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Telephone | 412-953-1043
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Fax | 412-374-9410
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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 | 211424L
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License Number State | PA
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