Individual
CHRISTINE SUE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
901 MONTGOMERY ST, DECORAH, IA 52101-2325
(563) 382-2911
(563) 387-3102
Mailing address
901 MONTGOMERY ST, DECORAH, IA 52101-2325
(563) 382-2911
(563) 387-3102
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D102488
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114972858
—
IA
Enumeration date
05/23/2006
Last updated
03/17/2018
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