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Individual

KELI KRNJAIC BAINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4320 SEMINARY RD, ALEXANDRIA, VA 22304-1535
(703) 766-9695
Mailing address
3021 O ST NW, WASHINGTON, DC 20007-3108
(202) 657-7187

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1026687
DC
367500000X
Certified Registered Nurse Anesthetist
Primary
0024172345
VA

Other

Enumeration date
11/20/2014
Last updated
04/03/2015
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