Kendra Knaga
Nurse Anesthetist, Certified Registered in De Soto, IL. Individual provider (NPI-1).
NPI number1891479960
StatusActive
Last updated in NPPESNov 12, 2024
Details
- NPI
- 1891479960
- Entity type
- Individual (NPI-1)
- Name
- Kendra Knaga
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 9, 2023
- Certification date
- Nov 12, 2024
- Last updated
- Nov 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 209030595 | IL | Yes |
| 163WC0200X | Registered Nurse, Critical Care Medicine | 041356464 | IL |
Practice location
85 BrooksideDe Soto, IL 62924-3900
Phone 630-649-0542
Mailing address
1 Hairpin DriveEdwardsville, IL 62026-0001
Phone 618-650-5688
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