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Individual

JILL M. KRYSTOFINSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
(610) 402-9099
(610) 402-9029
Mailing address
1245 S CEDAR CREST BLVD, SUITE #301, ALLENTOWN, PA 18103-6258
(610) 402-9099
(610) 402-9029

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN277643L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
070026
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1027795840001
PA
01
11803035
CAQH
PA
01
1466843
KHP CENTRAL
PA
01
1580834
GATEWAY
PA
01
2151119000
INDEP. BLUE CROSS
PA
01
50010797
CAPITAL ADVANTAGE
PA
01
82856
GEISINGER
PA
01
9109431
AETNA
PA
Enumeration date
09/27/2005
Last updated
03/25/2013
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