Individual
KELLY S MARX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-4562
Mailing address
301C US ROUTE 1, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
209-006356
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA103011
ME
Other
Enumeration date
01/09/2007
Last updated
10/17/2013
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