Individual
KELLIE LOGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
214 S 4TH ST, KREMMLING, CO 80459-5065
(970) 887-5800
Mailing address
PO BOX 399, KREMMLING, CO 80459-0399
(309) 202-1692
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
185347
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN.0993708-CRNA
CO
Other
Enumeration date
07/21/2014
Last updated
05/04/2021
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