Individual
MRS. ELIZABETH CLEARY KINGSTEDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
11416 YATES AVE N, CHAMPLIN, MN 55316-2908
(360) 356-2730
Mailing address
11416 YATES AVE N, CHAMPLIN, MN 55316-2908
(612) 360-9484
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R 206981-6
MN
Other
Enumeration date
09/29/2014
Last updated
12/12/2014
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