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Individual

LARA KJURSTON KNOWLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
400 W 16TH ST, PUEBLO, CO 81003-2745
(719) 584-4000
Mailing address
2060 N 50TH E, IDAHO FALLS, ID 83401-5784
(208) 313-0428

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
259162
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
C-APN.0000902-C-CRNA
CO

Other

Enumeration date
11/01/2017
Last updated
06/24/2021
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