Individual
JONATHAN C KIEPEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
(615) 327-4304
Mailing address
110 29TH AVE N, STE 202, NASHVILLE, TN 37203-1401
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
051262
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009919280
—
AL
01
—
3140576
BCBS NUMBER
TN
05
—
3630569
—
TN
05
—
74001371
—
KY
Enumeration date
08/02/2005
Last updated
06/20/2012
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