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Individual

SHELLY R KIRBY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
234 GOODMAN ST, CINCINNATI, OH 45219-2364
(513) 558-4194
(513) 558-0995
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5502
(513) 585-5502

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
COA 08747 NA
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200823140
IN
05
2637016
OH
05
74012600
KY
Enumeration date
06/21/2006
Last updated
05/31/2017
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