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NPI Code Detail

MEDICARE: KERRY LEONE-QUISENBERRY CRNA

MEDICARE:   KERRY  LEONE-QUISENBERRY  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 AnesthetistRN241500OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043216468
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERRY LEONE-QUISENBERRY CRNA
Provider Business Mailing Address
First Line : PO BOX 80690
Second Line :
City : CANTON
State : OH
Zip : 44708-0690
Country : US
Telephone Number : 330-363-7444
Fax Number : 330-363-7770
Provider Business Practice Location Address
First Line : 2600 SIXTH ST SW
Second Line :
City : CANTON
State : OH
Zip : 44710-1702
Country : US
Telephone Number : 330-452-9911
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2005
Last Update Date : 07/19/2022

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Directions to “ KERRY LEONE-QUISENBERRY CRNA” Practice Location

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