Individual
KRISTINA JEAN POLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
8008 WESTPARK DR, KAISER PERMANENTE TYSONS CORNER MEDICAL CENTER, MC LEAN, VA 22102-3109
(703) 287-6400
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0102202776
VA
207L00000X
Anesthesiology Physician
H0069445
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418033000
—
MD
Enumeration date
11/01/2006
Last updated
11/22/2021
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