Individual
KEVIN QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
89471
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
104105
WV
Other
Enumeration date
04/15/2019
Last updated
09/04/2019
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