Individual
MRS. KIMMERLE MILLER-LEONARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA,MAE
Contact information
Practice address
1030 PIONEER RD, TOPPENISH, WA 98948-9606
(509) 391-9434
Mailing address
PO BOX 2329, MOUNT VERNON, WA 98273-7329
(360) 466-2542
(360) 466-2682
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30002282
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0184061
DEPARTMENT OF LABOR AND INDUSTRIES
WA
01
—
2851MI
REGENCE BLUE SHIELD
WA
05
—
9618109
—
WA
01
—
9840642
CRIME VICTIMS
WA
Enumeration date
09/02/2005
Last updated
03/10/2014
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