Individual
KEVIN BALDASARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1241 SHAWHAN RD, MORROW, OH 45152-9695
(513) 865-5204
(513) 672-3323
Mailing address
PO BOX 632572, CINCINNATI, OH 45263-2572
(513) 672-4128
(513) 672-4479
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
256928
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
256928
LICENSE
OH
Enumeration date
12/07/2009
Last updated
06/27/2013
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