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General NPI Number Information
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NPI Number | 1659787646
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Entity Type | Individual
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Provider Name | KIERSTEN MICHAELE RHOADES CRNA
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Gender | Female
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Dates
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Enumeration Date | 07/10/2014
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Last Update Date | 03/18/2026
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Provider Practice Location Address
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Address Line | 2720 SUNSET BLVD
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-4810
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Country | US
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Telephone | 803-935-8538
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 CENTRAL AVE APT 352
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City | CHARLOTTE
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State | NC
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Zip | 28205-5193
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Country | US
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Telephone | 716-984-4367
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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 | 30578
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License Number State | SC
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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 | 6026
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License Number State | NC
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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 | 209.011618
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License Number State | IL
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