Kenneth Donald Klos Jr, CRNA is a
Nurse Anesthetist, Certified Registered based in Cook, Minnesota. Kenneth Donald Klos Jr is licensed to practice in Minnesota (license number R076202-1) and his current practice location is
7595 Timberlore Trl, Cook, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(218) 290-4381.
NPI number for Kenneth Donald Klos Jr is 1386646115 and his current mailing address is 7595 Timberlore Trl, Cook, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1386646115.
Provider's Profile
| Full Name | Kenneth Donald Klos Jr |
|---|
| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 7595 Timberlore Trl, Cook, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1386646115
- Provider Enumeration Date: 08/11/2005
- Last Update Date: 09/29/2011
Medical Identifiers
Medical identifiers for Kenneth Donald Klos Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1386646115 | NPI | - | NPPES |
| 891043000 | Medicaid | MN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R076202-1 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth Donald Klos Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kenneth Donald Klos Jr, CRNA
7595 Timberlore Trl,
Cook, MN 55723-8728
Ph: (218) 290-4381 | Kenneth Donald Klos Jr, CRNA
7595 Timberlore Trl,
Cook, MN 55723-8728
Ph: (218) 290-4381 |
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