Individual
KENNETH JOHN GRALL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
600 MARY STREET, EVANSVILLE, IN 47747-0001
(812) 450-2240
(812) 450-2710
Mailing address
PO BOX 3366, EVANSVILLE, IN 47732-3366
(812) 450-2240
(812) 450-2710
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28191766A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201279980
—
IN
05
—
7100345910
—
KY
Enumeration date
11/18/2014
Last updated
08/17/2016
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