Individual
JACK F KEARNS
Active
Individual
JACK F KEARNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
199762
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430070320
RAILROAD MEDICARE
—
Enumeration date
10/12/2006
Last updated
06/18/2008
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