Provider Demographics
NPI:1790551521
Name:DAMRELL, KIARA HOPE (RN)
Entity Type:Individual
Prefix:
First Name:KIARA
Middle Name:HOPE
Last Name:DAMRELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6247 HIGHWAY 136 W
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:KY
Mailing Address - Zip Code:42462-9521
Mailing Address - Country:US
Mailing Address - Phone:859-358-5738
Mailing Address - Fax:
Practice Address - Street 1:400 SE 4TH ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713-1206
Practice Address - Country:US
Practice Address - Phone:812-421-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1173567163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse