Individual
KRISTEN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
55 SCHANCK RD, SUITE 8A, FREEHOLD, NJ 07728-2964
(732) 431-9544
(732) 431-9313
Mailing address
55 SCHANCK RD, SUITE 8A, FREEHOLD, NJ 07728-2964
(732) 431-9544
(732) 431-9313
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26NR08801200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016539PJN
MEDICARE NUMBER
NJ
Enumeration date
01/18/2007
Last updated
01/11/2011
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