Provider Demographics
NPI:1346607876
Name:ECHOLS, KEVIN HEATH (CRNA)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:HEATH
Last Name:ECHOLS
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 1:8 HOPSON RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-2612
Mailing Address - Country:US
Mailing Address - Phone:678-613-1543
Mailing Address - Fax:
Practice Address - Street 1:8 HOPSON RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-2612
Practice Address - Country:US
Practice Address - Phone:678-613-1543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-28
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN253420367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered