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NPI Code Detail

MEDICARE: DONNA KODET CRNA

MEDICARE: DONNA KODET 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 AnesthetistR-130840-0MN

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 : 1477526721
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONNA KODET CRNA
Provider Business Mailing Address
First Line : 8681 EAGLE POINT BLVD
Second Line :
City : LAKE ELMO
State : MN
Zip : 55042-8628
Country : US
Telephone Number : 651-251-8021
Fax Number : 651-251-8050
Provider Business Practice Location Address
First Line : 1575 BEAM AVE
Second Line :
City : MAPLEWOOD
State : MN
Zip : 55109-1126
Country : US
Telephone Number : 651-735-0501
Fax Number : 651-735-1870
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/08/2006
Last Update Date : 10/04/2010

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