Individual
THOMAS J KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
8901 W. LINCOLN AVE, AURORA WEST ALLIS MEDICAL CENTER, WEST ALLIS, WI 53227
(414) 328-6000
(414) 328-8536
Mailing address
8901 W. LINCOLN AVE, AURORA WEST ALLIS MEDICAL CENTER, WEST ALLIS, WI 53227
(414) 328-6000
(414) 328-8536
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1154-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43284100
—
WI
01
—
KAVANTHO
MERCYCARE
WI
Enumeration date
01/05/2007
Last updated
10/07/2016
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