Individual
KELLIE K BIRCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
11011 SHERIDAN ST STE 106, HOLLYWOOD, FL 33026-1501
(954) 435-0101
(954) 435-0125
Mailing address
9500 S DADELAND BLVD STE 200, MIAMI, FL 33156-2866
(786) 530-3820
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN11010950
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117705200
—
FL
Enumeration date
08/19/2006
Last updated
07/10/2024
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