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NPI Code Detail

MEDICARE: FREDRICK KAMINSKY CRNA

MEDICARE: FREDRICK KAMINSKY CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist437033WI

General Provider Information

NPI Number : 1003899725
Entity Type Code : Individual
Provider Name (Legal Business Name) : FREDRICK KAMINSKY CRNA
Provider Business Mailing Address
First Line : 464 S SAINT JOSEPH AVE
Second Line :
City : ARCADIA
State : WI
Zip : 54612-1401
Country : US
Telephone Number : 608-323-3341
Fax Number : 608-323-2136
Provider Business Practice Location Address
First Line : 464 S SAINT JOSEPH AVE
Second Line :
City : ARCADIA
State : WI
Zip : 54612-1401
Country : US
Telephone Number : 608-323-3341
Fax Number : 608-323-2136
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2005
Last Update Date : 07/08/2007

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