Individual
SHARI LYNN KVIDAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN-RN
Contact information
Practice address
1615 GRANDE AVE SE, CEDAR RAPIDS, IA 52403-2221
(319) 777-4311
Mailing address
1615 GRANDE AVE SE, CEDAR RAPIDS, IA 52403-2221
(319) 777-4311
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
143111
IA
163WI0500X
Infusion Therapy Registered Nurse
143111
IA
163WW0000X
Wound Care Registered Nurse
143111
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
143111
COMPACT NURSING LICENSE NUMBER
IA
Enumeration date
09/30/2021
Last updated
09/30/2021
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