Provider Demographics
NPI:1104037696
Name:GURNEY, KEVIN P (CRNA)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:P
Last Name:GURNEY
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6602 APPLEVIEW ROAD
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908
Mailing Address - Country:US
Mailing Address - Phone:509-895-4970
Mailing Address - Fax:509-574-4481
Practice Address - Street 1:723 MEMORIAL STREET
Practice Address - Street 2:
Practice Address - City:PROSSER
Practice Address - State:WA
Practice Address - Zip Code:99350
Practice Address - Country:US
Practice Address - Phone:509-786-2222
Practice Address - Fax:509-788-6018
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007751367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered