Individual
KEVIN LIENESCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP, CRNA
Contact information
Practice address
701 LEWISTON ST, COTTONWOOD, ID 83522-9750
(208) 962-3251
Mailing address
PO BOX 267, GRANGEVILLE, ID 83530-0267
(206) 321-6509
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
143767
MT
367500000X
Certified Registered Nurse Anesthetist
Primary
59906
ID
367500000X
Certified Registered Nurse Anesthetist
AP60678113
WA
Other
Enumeration date
07/20/2016
Last updated
07/14/2025
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