MEDICARE: PATRICK BENSON KINUTHIA

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	1096015	TX
2	367500000X	Certified Registered Nurse Anesthetist	D185371	IA

General Provider Information

NPI Number	:	1689309593
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK BENSON KINUTHIA

Provider Business Mailing Address
First Line	:	6001 BARTON HILLS DR APT 514
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-2773
Country	:	US
Telephone Number	:	972-348-8750
Fax Number	:

Provider Business Practice Location Address
First Line	:	6001 BARTON HILLS DR APT 514
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76112-2773
Country	:	US
Telephone Number	:	972-348-8750
Fax Number	:

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

Provider Enumeration Date	:	07/24/2022
Last Update Date	:	09/18/2025

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