Provider Demographics
NPI:1598762163
Name:TOUPAL, KATHY ANN (CRNA)
Entity Type:Individual
Prefix:MS
First Name:KATHY
Middle Name:ANN
Last Name:TOUPAL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:ANN
Other - Last Name:GOODWIN AND MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7912 E 31ST CT
Mailing Address - Street 2:STE 210
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74145-1315
Mailing Address - Country:US
Mailing Address - Phone:918-392-4477
Mailing Address - Fax:918-392-4465
Practice Address - Street 1:1100 CENTRAL AVE SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4930
Practice Address - Country:US
Practice Address - Phone:505-841-1234
Practice Address - Fax:505-841-1956
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0073935367500000X
NMCRNA - 01058367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM202040876OtherPHP SALUD
OK200041630AMedicaid
OK900522349OtherMEDICARE GROUP PIN
OK900522349OtherMEDICARE GROUP PIN