Provider Demographics
NPI:1972692663
Name:HURTIG, KIM (CRNA)
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:HURTIG
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 1:1315 8TH ST
Mailing Address - Street 2:
Mailing Address - City:HULL
Mailing Address - State:IA
Mailing Address - Zip Code:51239-7604
Mailing Address - Country:US
Mailing Address - Phone:712-439-1251
Mailing Address - Fax:
Practice Address - Street 1:1202 21ST AVE
Practice Address - Street 2:
Practice Address - City:ROCK VALLEY
Practice Address - State:IA
Practice Address - Zip Code:51247-1420
Practice Address - Country:US
Practice Address - Phone:712-476-8000
Practice Address - Fax:712-476-8090
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO70350367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered