Individual
KATHERINE KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
600 7TH ST SE, CEDAR RAPIDS, IA 52401-2112
(319) 221-8800
(319) 221-8787
Mailing address
PO BOX 1824, CEDAR RAPIDS, IA 52406-1824
(319) 369-4505
(319) 369-4677
Taxonomy
Speciality
Code
Description
License number
State
363LC0200X
Critical Care Medicine Nurse Practitioner
Primary
078725
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0470948
—
IA
Enumeration date
03/27/2006
Last updated
10/25/2007
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