Individual
KIMBERLY RONAE NADZAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3622 BELMONT AVE, 1, YOUNGSTOWN, OH 44505-1450
(330) 759-9350
(330) 759-9387
Mailing address
3622 BELMONT AVE, 1, YOUNGSTOWN, OH 44505-1450
(330) 759-9350
(330) 759-9387
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
083420
OH
367500000X
Certified Registered Nurse Anesthetist
RN272694
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12105017
CAQH
OH
05
—
3031703
—
OH
Enumeration date
03/01/2010
Last updated
10/22/2012
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