Provider Demographics
NPI:1659801918
Name:KREUTER, KATELYNN E (CRNA)
Entity Type:Individual
Prefix:
First Name:KATELYNN
Middle Name:E
Last Name:KREUTER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 MAIN ST STE 209
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-2685
Mailing Address - Country:US
Mailing Address - Phone:716-836-7510
Mailing Address - Fax:716-836-7511
Practice Address - Street 1:2157 MAIN ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-2648
Practice Address - Country:US
Practice Address - Phone:716-836-7510
Practice Address - Fax:716-836-7511
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY431215367500000X
NY643764367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered