Individual
NICOLE KAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
30 MEDICAL CENTER BLVD, SUITE 305, UPLAND, PA 19013
(610) 874-6448
(610) 876-7399
Mailing address
914 SOUTH AVENUE, APT A-15, SECANE, PA 19018
(781) 718-9358
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN560901
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN560901
LICENSE
PA
Enumeration date
01/22/2008
Last updated
01/22/2008
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