Individual
MRS. KRISTIN CLICKETT LASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
180 PARKWOOD DRIVE, HUGH CHATHAM MEMORIAL HOSPITAL, ELKIN, NC 28621
(336) 527-7000
(314) 996-8479
Mailing address
155 ZEPHYR MOUNTAIN PARK RD, STATE ROAD, NC 28676-9021
(336) 413-6735
(314) 996-8479
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2003009222
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
$$$$$$$$$
—
IL
05
—
919241109
—
MO
Enumeration date
07/14/2006
Last updated
06/24/2021
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