Basic Information
Provider Information
NPI: 1922033182
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: NAWN
FirstName: KRISTEN
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: GRAEF
OtherFirstName: KRISTEN
OtherMiddleName: A
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNA
OtherLastNameType: 1
Mailing Information
Address1: 1150 VARNUM ST NE
Address2:  
City: WASHINGTON
State: DC
PostalCode: 20017
CountryCode: US
TelephoneNumber: 2022697000
FaxNumber:  
Practice Location
Address1: 1150 VARNUM ST NE
Address2:  
City: WASHINGTON
State: DC
PostalCode: 20017
CountryCode: US
TelephoneNumber: 2022697000
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/12/2006
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
163W00000XRN962988DCY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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