Individual
RANDY E KILNOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
7500 MERCY RD STE 1355, OMAHA, NE 68124-2319
(402) 717-4866
Mailing address
7261 MERCY RD, OMAHA, NE 68124-2311
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
111032
IA
367500000X
Certified Registered Nurse Anesthetist
Primary
101525
NE
367500000X
Certified Registered Nurse Anesthetist
D154760
IA
Other
Enumeration date
11/28/2018
Last updated
06/13/2019
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