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General NPI Number Information
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NPI Number | 1598833493
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Entity Type | Individual
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Provider Name | AI LIEN KOWALSKI CRNA
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Gender | Female
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 09/23/2021
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Provider Practice Location Address
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Address Line | 100 MALLARD CREEK RD SUITE 320
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City | LOUISVILLE
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State | KY
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Zip | 40207-4194
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Country | US
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Telephone | 502-690-8782
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Fax | 502-459-0923
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Provider Business Mailing Address
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Address Line | 11438 FRESHWATER RIDGE DR
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City | RIVERVIEW
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State | FL
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Zip | 33569-2060
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Country | US
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Telephone | 502-424-3867
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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 | 1092643
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 3005008
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 3005008
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 403331-01
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License Number State | NY
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