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PATRICIA L KIERNAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
905 13TH ST SE, BONDURANT, IA 50035-4434
(641) 486-8301
Mailing address
511 LAUREL STREET, DES MOINES, IA 50314

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
209.009023
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
D057697
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0272856
IA
01
32968
WELLMARK BCBS OF IA
IA
01
430078051
PGBA RR MEDICARE
01
A013
TRIWEST
01
IA0112
JOHN DEERE HEALTH
IA
Enumeration date
11/18/2005
Last updated
09/04/2012
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