Individual
KEVIN L O'LENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8144 E CACTUS RD, SUITE 800, SCOTTSDALE, AZ 85260-5266
(480) 596-8525
(480) 596-8522
Mailing address
3432 E GEORGIA AVE, PHOENIX, AZ 85018-1501
(602) 505-1558
(602) 956-0860
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
073679
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA0407
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0424370
BLUE CROSS BLUE SHIELD
AZ
05
—
998601
—
AZ
01
—
AX0494
HEALTHNET
AZ
01
—
P00313023
RAILROAD MEDICARE
—
Enumeration date
07/18/2006
Last updated
07/23/2019
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