Provider Demographics
NPI:1811060973
Name:MALIN, JOEL M (CRNA)
Entity type:Individual
Prefix:MR
First Name:JOEL
Middle Name:M
Last Name:MALIN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
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Mailing Address - Street 1:1890 JOHN F KENNEDY RD
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-3800
Mailing Address - Country:US
Mailing Address - Phone:563-556-8332
Mailing Address - Fax:563-556-8334
Practice Address - Street 1:1890 JOHN F KENNEDY RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52002-3800
Practice Address - Country:US
Practice Address - Phone:563-556-8332
Practice Address - Fax:563-556-8334
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI156658367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered