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General NPI Number Information
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NPI Number | 1760464200
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Entity Type | Individual
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Provider Name | JEFFREY J KALVIG CRNA
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Gender | Male
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 1316 S MAIN
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City | CLARION
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State | IA
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Zip | 50525
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Country | US
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Telephone | 515-532-2811
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Fax | 515-532-9336
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Provider Business Mailing Address
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Address Line | 1316 S MAIN
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City | CLARION
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State | IA
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Zip | 50525
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Country | US
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Telephone | 515-532-2811
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Fax | 515-532-9336
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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 | 068252
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License Number State | IA
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