Provider Demographics
NPI:1538106851
Name:HOWARD, KATHLEEN GRAHAM (CRNA)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:GRAHAM
Last Name:HOWARD
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:MARIE
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1410 6TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MASON CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50401-4818
Mailing Address - Country:US
Mailing Address - Phone:305-332-3180
Mailing Address - Fax:305-441-6587
Practice Address - Street 1:2843 S BAYSHORE DR APT 16C
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-6032
Practice Address - Country:US
Practice Address - Phone:305-332-3180
Practice Address - Fax:305-441-6587
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 2227332367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL300990400Medicaid
FLG2531Medicare ID - Type Unspecified