Individual
KELLY M HAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R035339
SD
367500000X
Certified Registered Nurse Anesthetist
Primary
CR000818
SD
Other
Enumeration date
04/26/2013
Last updated
04/26/2013
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