Individual
KATHRYN CLARK DEARBORN
Active
Individual
KATHRYN CLARK DEARBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
615852-1
NY
367500000X
Certified Registered Nurse Anesthetist
CRA-100084
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80574823
—
CO
01
—
COAAA4235
CO MEDICARE
CO
01
—
P01080610
MEDICARE RAILROAD
CO
Enumeration date
10/18/2011
Last updated
05/19/2023
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