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PETER WHITEHEAD KEARNS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
425 W 5TH ST, EAST LIVERPOOL, OH 43920-2405
(330) 386-2017
Mailing address
4135 BOARDMAN CANFIELD RD, SUITE 101, CANFIELD, OH 44406-9803
(330) 286-5330
(330) 286-5396

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN251756-1
OH
367500000X
Certified Registered Nurse Anesthetist
RN354157L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0017673070004
PA
01
12215037
CAQH
01
218848TV6
MEDICARE PTAN
PA
05
2236066
OH
01
2615680
HIGHMARK BCBS
PA
01
8226988
MEDICARE PTAN
OH
01
P01613589
MEDICARE RAILROAD
OH
Enumeration date
08/17/2006
Last updated
04/21/2016
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