Provider Demographics
NPI:1588705909
Name:CAIN, KYRON L (CRNA)
Entity type:Individual
Prefix:
First Name:KYRON
Middle Name:L
Last Name:CAIN
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:3655 MITCHELL ST
Mailing Address - Street 2:BOX 690001
Mailing Address - City:LORIS
Mailing Address - State:SC
Mailing Address - Zip Code:29569-9601
Mailing Address - Country:US
Mailing Address - Phone:843-716-7000
Mailing Address - Fax:843-716-7093
Practice Address - Street 1:3655 MITCHELL ST
Practice Address - Street 2:BOX 690001
Practice Address - City:LORIS
Practice Address - State:SC
Practice Address - Zip Code:29569-9601
Practice Address - Country:US
Practice Address - Phone:843-716-7000
Practice Address - Fax:843-716-7093
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2024-03-20
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Provider Licenses
StateLicense IDTaxonomies
SC73174367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q324243387Medicare UPIN