Individual
JOSHUA BLAKE KIENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1201 HEALTH CENTER PKWY, YUKON, OK 73099-6381
(405) 717-6800
(405) 717-7964
Mailing address
PO BOX 13618, OKLAHOMA CITY, OK 73113-1618
(405) 715-3610
(405) 715-3612
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1496375052
KS
163W00000X
Registered Nurse
66888
OK
367500000X
Certified Registered Nurse Anesthetist
556986
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
66888
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200677680A
—
KS
Enumeration date
05/11/2010
Last updated
07/21/2022
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