Organization
KS TKO ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENDRA SMITH CRNA (CEO)
(208) 681-8157
Entity
Organization
Contact information
Practice address
1721 MAGNAVOX WAY STE A, FORT WAYNE, IN 46804-1537
(260) 250-0001
Mailing address
5716 W 400 S, HUNTINGTON, IN 46750-9135
(208) 681-8157
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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