Basic Information
| Provider Information | |||||||||
| NPI: | 1437640679 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THORNE | ||||||||
| FirstName: | KYLE | ||||||||
| MiddleName: | MOORE | ||||||||
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| Credential: | CRNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 131 WARREN ST APT 2 | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 033012937 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4694388585 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 PILLSBURY ST STE 202 | ||||||||
| Address2: | |||||||||
| City: | CONCORD | ||||||||
| State: | NH | ||||||||
| PostalCode: | 03301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6032234776 | ||||||||
| FaxNumber: | 6032282113 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2018 | ||||||||
| LastUpdateDate: | 05/08/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 120488 | NH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.