Individual
KRISTINN MARIE SERGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1044 BELMONT AVE, YOUNGSTOWN, OH 44504-1006
(330) 480-3658
(330) 480-3439
Mailing address
4135 BOARDMAN CANFIELD RD, SUITE 101, CANFIELD, OH 44406-9803
(330) 286-5330
(330) 286-5396
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN315352
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
105522
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000921157
ANTHEM BCBS
OH
05
—
0120977
—
OH
01
—
13550681
CAQH
—
01
—
H455340
MEDICARE PTAN
OH
Enumeration date
03/16/2015
Last updated
10/02/2018
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