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Individual

KRISTEN M SHAKOUR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3777
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
(216) 383-6614

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN312748
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3020500
OH
01
P00839056
MEDICARE RAILROAD
OH
Enumeration date
12/16/2009
Last updated
11/23/2020
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