Individual
MRS. KRISTINA MARIE DEROLF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 MACARTHUR BLVD, MUNSTER, IN 46321-2901
(219) 836-1600
Mailing address
901 MACARTHUR BLVD, MUNSTER, IN 46321-2901
(219) 836-1600
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041342122
IL
163W00000X
Registered Nurse
28200112A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
209029863
IL
367500000X
Certified Registered Nurse Anesthetist
28200112A
IN
Other
Enumeration date
10/15/2011
Last updated
06/13/2024
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