Individual
KIRSTEN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
721 W 111TH ST, LOS ANGELES, CA 90044-4234
(323) 321-3764
Mailing address
721 W 111TH ST, LOS ANGELES, CA 90044-4234
(323) 321-3764
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95267948
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95002604
CA
Other
Enumeration date
07/13/2024
Last updated
07/23/2025
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