Provider Demographics
NPI:1316369499
Name:ZEIGLER, KERRY (CRNA)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:ZEIGLER
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:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:555 EAST CHEVES STREET
Practice Address - Street 2:MCLEOD REGIONAL MEDICAL CENTER
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506
Practice Address - Country:US
Practice Address - Phone:843-777-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-09
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0993125-CRNA367500000X
SC18643367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered