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Individual

KRISTAIN DRU CARROLL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1008 N MAIN ST, SIKESTON, MO 63801
(573) 275-0214
Mailing address
301 HILLVIEW ST, CAPE GIRARDEAU, MO 63703-6329
(573) 275-0214

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2011022765
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
2017012413
MO

Other

Enumeration date
12/11/2016
Last updated
07/03/2018
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