Individual
KRISTEN S TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
22 BRAMHALL ST, DEPT OF ANESTHESIOLOGY, PORTLAND, ME 04102-3134
(207) 662-4562
Mailing address
22 BRAMHALL ST, DEPT OF ANESTHESIOLOGY, PORTLAND, ME 04102-3134
(207) 662-4562
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AA113005
ME
Other
Enumeration date
02/17/2011
Last updated
12/01/2014
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