Randy A Kienstra
Pediatric Nephrologist
301 N 8th St
Springfield
, Illinois 62701-1041
Randy A Kienstra
Pediatric Nephrologist
301 N 8th St
Springfield
, Illinois 62701-1041
(217) 545-1884
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About
Features
Specialties
- Pediatric Nephrologist
Languages spoken
- English
Location
First Address
- Randy A Kienstra
- Po Box 19639
- Springfield, IL
- Zip : 62794-9639
- Fax : (217) 545-1884
- Phone : (217) 545-7578
Second Address
- Randy A Kienstra
- 301 N 8th St
- Springfield, IL
- Zip : 62701-1041
- Fax : (217) 545-4117
- Phone : (217) 545-0654
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0210X | Pediatric Nephrologist | IL |
National Provider Identifier
| NPI | 1609850478 |
|---|---|
| Provider Name | Randy A Kienstra |
| First Address | Springfield, IL 62794-9639 |
| Second Address | Springfield, IL 62701-1041 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/12/2005 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| C37844 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.