Individual
KIMBERLY RODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1324 S. SHORE DRIVE APT. G07, ERIE, PA 16505
(307) 631-1517
Mailing address
1324 S. SHORE DRIVE APT. G07, ERIE, PA 16505
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN654367
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9436121
FL
Other
Enumeration date
05/11/2016
Last updated
08/24/2016
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