Provider Demographics
NPI:1528836509
Name:KUESER, KATHLEEN MADISON (DNP, CRNA, APRN)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MADISON
Last Name:KUESER
Suffix:
Gender:F
Credentials:DNP, CRNA, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12858 EQUESTRIAN TRL
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33330-1270
Mailing Address - Country:US
Mailing Address - Phone:954-224-5772
Mailing Address - Fax:
Practice Address - Street 1:8900 N KENDALL DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-2197
Practice Address - Country:US
Practice Address - Phone:786-596-3621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-19
Last Update Date:2024-01-03
Deactivation Date:2023-12-28
Deactivation Code:
Reactivation Date:2024-01-03
Provider Licenses
StateLicense IDTaxonomies
FL11030389367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered