Provider Demographics
NPI:1619405263
Name:KRAHL, KORY (CRNA, DNAP)
Entity Type:Individual
Prefix:DR
First Name:KORY
Middle Name:
Last Name:KRAHL
Suffix:
Gender:M
Credentials:CRNA, DNAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 KELLER DR
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:NE
Mailing Address - Zip Code:69162-2569
Mailing Address - Country:US
Mailing Address - Phone:970-379-3886
Mailing Address - Fax:
Practice Address - Street 1:1000 POLE CREEK XING
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:NE
Practice Address - Zip Code:69162-2901
Practice Address - Country:US
Practice Address - Phone:308-254-5825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE101424367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered