Individual
KATHLEEN FLITCRAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
501 W. FRONT ST., ELMER, NJ 08318-2101
(856) 363-1000
(856) 358-0994
Mailing address
PO BOX 650782, DALLAS, TX 75265-0782
(302) 733-0806
(302) 733-0854
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
26NO11053100
NJ
163W00000X
Registered Nurse
L1-0028494
DE
367500000X
Certified Registered Nurse Anesthetist
Primary
26NJ00238000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
075412
AANA NUMBER
NJ
01
—
P00795659
RAILROAD MEDICARE PTAN
NJ
Enumeration date
07/10/2006
Last updated
06/20/2012
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