Provider Demographics
NPI:1073749271
Name:GINN, KATHLEEN S (CRNA)
Entity Type:Individual
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First Name:KATHLEEN
Middle Name:S
Last Name:GINN
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Gender:F
Credentials:CRNA
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Mailing Address - Street 1:255 W MICHIGAN AVE
Mailing Address - Street 2:PO BOX 1123
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-2218
Mailing Address - Country:US
Mailing Address - Phone:517-787-6440
Mailing Address - Fax:517-787-4146
Practice Address - Street 1:2 READS WAY
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-1607
Practice Address - Country:US
Practice Address - Phone:302-709-4706
Practice Address - Fax:302-709-4551
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
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Provider Licenses
StateLicense IDTaxonomies
DEL1-0017193367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered