Provider Demographics
NPI:1326015215
Name:KALMAN, JEANETTE (CRNA)
Entity type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:KALMAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 BOARDMAN CANFIELD RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-4226
Mailing Address - Country:US
Mailing Address - Phone:330-629-2888
Mailing Address - Fax:330-629-8940
Practice Address - Street 1:1011 BOARDMAN CANFIELD RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-4226
Practice Address - Country:US
Practice Address - Phone:330-629-2888
Practice Address - Fax:330-629-8940
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN139875367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000221185OtherUNISON
OH0583328OtherBCMH
OH750673OtherBUCKEYE MEDICAID
OH000000515993OtherANTHEM
OH414986OtherWELLCARE MEDICAID
OH0213683Medicaid
OH7316581OtherAETNA
OHP00668457OtherMEDICARE RAILROAD
OH750673OtherBUCKEYE MEDICAID