Individual
KELLY ELIZABETH KUCZWARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(888) 539-8781
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
(800) 926-8273
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
719042
CA
163WC0200X
Critical Care Medicine Registered Nurse
719042
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
4300
CA
Other
Enumeration date
05/09/2012
Last updated
08/04/2023
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