Provider Demographics
NPI:1801232210
Name:KILJANDER, TAWNA LEA (RN CNOR RNFA)
Entity Type:Individual
Prefix:
First Name:TAWNA
Middle Name:LEA
Last Name:KILJANDER
Suffix:
Gender:F
Credentials:RN CNOR RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 ARCADIA AVE
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-2230
Mailing Address - Country:US
Mailing Address - Phone:307-660-7503
Mailing Address - Fax:307-682-3432
Practice Address - Street 1:616 ARCADIA AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-2230
Practice Address - Country:US
Practice Address - Phone:307-660-7503
Practice Address - Fax:307-682-3432
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY21791163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant