Individual
MARIAH KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CRNA
Contact information
Practice address
404 W FOUNTAIN ST, ALBERT LEA, MN 56007-2437
(507) 373-2384
Mailing address
404 W FOUNTAIN ST, ALBERT LEA, MN 56007-2437
(507) 373-2384
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2323
MN
Other
Enumeration date
02/21/2019
Last updated
10/02/2020
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