Individual
LISA C KREITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
HWY 15 SOUTH, SPIRIT LAKE, IA 51360
(712) 336-1230
Mailing address
400 E 10TH ST, WACONIA, MN 55387-4552
(952) 442-9770
(952) 442-3630
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
078753
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3078113
—
IA
01
—
51572
BLUE CROSS OF IOWA
IA
Enumeration date
07/10/2006
Last updated
07/12/2021
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