Basic Information
Provider Information
NPI: 1154358430
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCGIRR
FirstName: KAY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 400 E 10TH ST
Address2:  
City: WACONIA
State: MN
PostalCode: 553874552
CountryCode: US
TelephoneNumber: 9524429770
FaxNumber: 9524423630
Practice Location
Address1: 1190 WAIANUENUE AVE
Address2:  
City: HILO
State: HI
PostalCode: 967202020
CountryCode: US
TelephoneNumber: 8089746700
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/26/2006
LastUpdateDate: 04/29/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN-37524HIY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

ID Information
IDTypeStateIssuerDescription
022527-601HIBLUE CROSS OF HIOTHER
000202527605HI MEDICAID


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