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Individual

TIMOTHY G KISCOE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
7500 STATE RD, CINCINNATI, OH 45255-2439
(513) 624-4500
Mailing address
4921 RELLEUM AVE, CINCINNATI, OH 45238-3805
(859) 803-5302

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
308963
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.019711
OH

Other

Enumeration date
04/02/2018
Last updated
01/10/2019
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