Basic Information
Provider Information
NPI: 1386613271
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KUERSCHEN
FirstName: KATHRYN
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3106 BARNARD RD
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379212906
CountryCode: US
TelephoneNumber: 8656911920
FaxNumber:  
Practice Location
Address1: 990 OAK RIDGE TPKE
Address2: ANESTHESIA DEPT
City: OAK RIDGE
State: TN
PostalCode: 378306976
CountryCode: US
TelephoneNumber: 8654811112
FaxNumber: 7702371124
Other Information
ProviderEnumerationDate: 03/14/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X80969TNY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

ID Information
IDTypeStateIssuerDescription
8096901TNRN LICENSE #OTHER


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