Provider Demographics
NPI:1861642225
Name:KERSCHEN, MARK A (CRNA)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:KERSCHEN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8080 E CENTRAL AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2368
Mailing Address - Country:US
Mailing Address - Phone:316-686-7327
Mailing Address - Fax:316-858-1556
Practice Address - Street 1:8080 E CENTRAL AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2368
Practice Address - Country:US
Practice Address - Phone:316-686-7327
Practice Address - Fax:316-858-1556
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS13-85266-121367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered