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General NPI Number Information
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NPI Number | 1376198911
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Entity Type | Individual
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Provider Name | JOEL KIRSCHBAUM CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/08/2019
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Last Update Date | 01/10/2020
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Provider Practice Location Address
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Address Line | 4960 NORTON HEALTHCARE BLVD
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City | LOUISVILLE
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State | KY
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Zip | 40241-2831
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Country | US
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Telephone | 502-446-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1037 SADDLESTONE DR
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City | HERMITAGE
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State | TN
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Zip | 37076-2973
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Country | US
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Telephone |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 223049
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License Number State | TN
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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 | 3014181
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License Number State | KY
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