Provider Demographics
NPI:1942551163
Name:KOHLER, KATHERINE M (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:M
Last Name:KOHLER
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 1:17600 CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-6339
Mailing Address - Country:US
Mailing Address - Phone:402-206-1117
Mailing Address - Fax:
Practice Address - Street 1:17600 CEDAR AVE
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55044-6339
Practice Address - Country:US
Practice Address - Phone:952-232-4185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK34278163W00000X
MN2333746163W00000X
AK408367500000X
MN1893367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse