Provider Demographics
NPI:1083661466
Name:HEYN, KARI JOY (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:KARI
Middle Name:JOY
Last Name:HEYN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 20TH ST
Mailing Address - Street 2:
Mailing Address - City:BARABOO
Mailing Address - State:WI
Mailing Address - Zip Code:53913-3346
Mailing Address - Country:US
Mailing Address - Phone:218-308-1048
Mailing Address - Fax:
Practice Address - Street 1:27040 COUNTY ROAD 9
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-5456
Practice Address - Country:US
Practice Address - Phone:218-751-6405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1542130367500000X, 163W00000X
WI3951-33367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN054988600Medicaid
MN054988600Medicaid