Provider Demographics
NPI:1871580803
Name:YURKO, KYRA A (CRNA)
Entity type:Individual
Prefix:
First Name:KYRA
Middle Name:A
Last Name:YURKO
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 1:1245 S CEDAR CREST BLVD
Mailing Address - Street 2:SUITE #301
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6258
Mailing Address - Country:US
Mailing Address - Phone:610-402-9099
Mailing Address - Fax:610-402-9029
Practice Address - Street 1:1200 S CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6202
Practice Address - Country:US
Practice Address - Phone:610-402-9099
Practice Address - Fax:610-402-9029
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN520951L163W00000X
PA052980367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1344348OtherFIRST PRIORITY
PA03226301OtherCAPITAL ADVANTAGE
PA82874OtherGEISINGER
PA1027812410001Medicaid
PA11776602OtherCAQH
PA1344348OtherKHP CENTRAL
PA1585283OtherGATEWAY
PA2036925000OtherINDEP. BLUE CROSS
PA9127475OtherAETNA
PA1344348OtherHIGHMARK
PA1344348OtherKHP CENTRAL
PA053600QCYMedicare PIN
PA2036925000OtherINDEP. BLUE CROSS