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General NPI Number Information
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NPI Number | 1871575456
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Entity Type | Individual
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Provider Name | PATRICIA L KIERNAN CRNA
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Gender | Female
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 09/04/2012
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Provider Practice Location Address
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Address Line | 905 13TH ST SE
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City | BONDURANT
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State | IA
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Zip | 50035-4434
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Country | US
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Telephone | 641-486-8301
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Fax |
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Provider Business Mailing Address
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Address Line | 511 LAUREL STREET
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City | DES MOINES
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State | IA
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Zip | 50314
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | D057697
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License Number State | IA
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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 | 209.009023
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License Number State | IL
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