MEDICARE: MS. MICKI S. KIETA 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
1	367500000X	Certified Registered Nurse Anesthetist	AP03115	LA

Other Identifiers

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

General Provider Information

NPI Number	:	1417931791
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICKI S. KIETA CRNA

Provider Business Mailing Address
First Line	:	PO BOX 60475
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70596-0475
Country	:	US
Telephone Number	:	337-988-1890
Fax Number	:

Provider Business Practice Location Address
First Line	:	4212 W CONGRESS ST
Second Line	:	SUITE 3200
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-6765
Country	:	US
Telephone Number	:	337-981-3546
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	07/16/2007

Similar Medicare Providers

1568469377 — ESMOND ANTHONY BARKER MD
Practice Location Address:

4212 W CONGRESS ST , SUITE 1800 A
LAFAYETTE, LA
70506-6765

Practice Phone: 337-981-7677
Practice Fax: 337-981-7678

1801894217 — DR. LINDA K OGE M.D.
Practice Location Address:

4212 W CONGRESS ST
LAFAYETTE, LA
70506-6765

Practice Phone: 337-988-8811
Practice Fax: 337-988-8844

1275521981 — DR. STEPHEN G REES MD
Practice Location Address:

4212 W CONGRESS ST
LAFAYETTE, LA
70506-6765

Practice Phone: 337-703-4481
Practice Fax:

1033193370 — STELLA M. SOUTHER NP
Practice Location Address:

4212 W CONGRESS ST , SUITE 3200
LAFAYETTE, LA
70506-6765

Practice Phone: 337-981-3546
Practice Fax:

1912981218 — MONICA STUTES CRNA
Practice Location Address:

4212 W CONGRESS ST , SUITE 3200
LAFAYETTE, LA
70506-6765

Practice Phone: 337-981-3546
Practice Fax:

1447235791 — THOMAS MCNEIL CRNA
Practice Location Address:

4212 W CONGRESS ST , SUITE 3200
LAFAYETTE, LA
70506-6765

Practice Phone: 337-981-3546
Practice Fax:

Directions to “ MS. MICKI S. KIETA CRNA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.