Individual
MS. KIMBERLY A QUEENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP CRNA
Contact information
Practice address
1 WYOMING ST, DAYTON, OH 45409-2722
(937) 208-6173
Mailing address
1956 E SPRING VALLEY PIKE, DAYTON, OH 45458-2800
(593) 741-6365
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN167488
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000280487
ANTHEM
OH
05
—
2351968
—
OH
01
—
P00023607
RAILROAD MEDICARE
OH
Enumeration date
07/15/2006
Last updated
05/29/2015
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