Provider Demographics
NPI:1013330547
Name:LEDVINA, KRISTIN A (MSN, RN, CRNA)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:A
Last Name:LEDVINA
Suffix:
Gender:F
Credentials:MSN, RN, CRNA
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:A
Other - Last Name:BOSWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN, CRNA
Mailing Address - Street 1:2620 SW 20TH CIR
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-2295
Mailing Address - Country:US
Mailing Address - Phone:515-554-5777
Mailing Address - Fax:
Practice Address - Street 1:411 LAUREL ST
Practice Address - Street 2:SUITE 3170
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3017
Practice Address - Country:US
Practice Address - Phone:515-283-0463
Practice Address - Fax:515-283-0794
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2017-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA117299163W00000X
IAD117299367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse